Healthcare Provider Details

I. General information

NPI: 1649367459
Provider Name (Legal Business Name): JOSEPH HILLEL BASKIN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 06/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1670 UPHAM DR SUITE 130
COLUMBUS OH
43210-1250
US

IV. Provider business mailing address

114 N MERKLE RD
BEXLEY OH
43209-1554
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-8283
  • Fax:
Mailing address:
  • Phone: 617-938-9480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number220328
License Number StateMA
# 2
Primary TaxonomyN
Taxonomy Code2084F0202X
TaxonomyForensic Psychiatry Physician
License Number35.091823
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: