Healthcare Provider Details

I. General information

NPI: 1811577901
Provider Name (Legal Business Name): JESSICA LOVE BYAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2021
Last Update Date: 06/17/2026
Certification Date: 06/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6076 WHIPPLE AVE NW
NORTH CANTON OH
44720-7616
US

IV. Provider business mailing address

6076 WHIPPLE AVE NW
NORTH CANTON OH
44720-7616
US

V. Phone/Fax

Practice location:
  • Phone: 330-433-1777
  • Fax:
Mailing address:
  • Phone: 330-433-1777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.156260
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: