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NPI Code Detail

MEDICARE: MRS. ESTHER GRACE PABLO KANAYJORN MD

MEDICARE:  MRS. ESTHER GRACE PABLO KANAYJORN  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician35077853-KOH

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1363844OTHEROHRHC MEDICARE FACILITY #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
22122096001OTHEROHCIGNA
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
47724279OTHEROHAETNA
5000000184923OTHEROHANTHEM BC/BS
60401451OTHEROHUNITED HEALTH CARE
7MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1043202187
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ESTHER GRACE PABLO KANAYJORN MD
Provider Business Mailing Address
First Line : 104 ERIN COURT
Second Line :
City : HILLSBORO
State : OH
Zip : 45133-0070
Country : US
Telephone Number : 937-393-5781
Fax Number : 937-393-5784
Provider Business Practice Location Address
First Line : 1092 JEFFERSON ST
Second Line :
City : GREENFIELD
State : OH
Zip : 45123-8319
Country : US
Telephone Number : 937-981-1121
Fax Number : 937-981-5660
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/16/2005
Last Update Date : 02/19/2008

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Directions to “ MRS. ESTHER GRACE PABLO KANAYJORN MD” Practice Location

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