Healthcare Provider Details

I. General information

NPI: 1740786383
Provider Name (Legal Business Name): CHALON JOHN FIKE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: C.J. FIKE MD

II. Dates (important events)

Enumeration Date: 04/03/2018
Last Update Date: 10/05/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1835 FRANKS PKWY
UNIONTOWN OH
44685-6249
US

IV. Provider business mailing address

1835 FRANKS PKWY
UNIONTOWN OH
44685-6249
US

V. Phone/Fax

Practice location:
  • Phone: 800-237-8662
  • Fax:
Mailing address:
  • Phone: 800-237-8662
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35141319
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: