Healthcare Provider Details

I. General information

NPI: 1851659981
Provider Name (Legal Business Name): HAIQIAO JIAO MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/26/2012
Last Update Date: 01/04/2023
Certification Date: 01/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3925 EMBASSY PKWY STE 200
AKRON OH
44333
US

IV. Provider business mailing address

3925 EMBASSY PKWY STE 200
AKRON OH
44333-8400
US

V. Phone/Fax

Practice location:
  • Phone: 330-668-4055
  • Fax: 330-668-4077
Mailing address:
  • Phone: 330-668-4040
  • Fax: 330-668-4077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number52137
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License Number35.146616
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number52137
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: