Healthcare Provider Details

I. General information

NPI: 1114954948
Provider Name (Legal Business Name): JEFFREY L. PAY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2640 W MARKET ST
FAIRLAWN OH
44333-4202
US

IV. Provider business mailing address

2640 W MARKET ST
FAIRLAWN OH
44333-4202
US

V. Phone/Fax

Practice location:
  • Phone: 330-864-1916
  • Fax: 330-864-1924
Mailing address:
  • Phone: 330-864-1916
  • Fax: 330-864-1924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number34008716
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: