Healthcare Provider Details

I. General information

NPI: 1104236488
Provider Name (Legal Business Name): MATTHEW NICHOLAS JAYKEL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2014
Last Update Date: 08/17/2020
Certification Date: 08/17/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 PARK WEST BLVD STE 330
AKRON OH
44320-4226
US

IV. Provider business mailing address

1 PARK WEST BLVD STE 330
AKRON OH
44320-4226
US

V. Phone/Fax

Practice location:
  • Phone: 330-835-5533
  • Fax:
Mailing address:
  • Phone: 330-835-5533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number35.138695
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: