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NPI Code Detail

MEDICARE: DR. JOHN A BACIOCCO MD

MEDICARE: DR. JOHN A BACIOCCO 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
1207Q00000XFamily Medicine Physician3695AK

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1124005731
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOHN A BACIOCCO MD
Provider Business Mailing Address
First Line : 222 TONGASS DR
Second Line :
City : SITKA
State : AK
Zip : 99835-9416
Country : US
Telephone Number : 907-966-2411
Fax Number : 907-966-8606
Provider Business Practice Location Address
First Line : 222 TONGASS DR
Second Line :
City : SITKA
State : AK
Zip : 99835-9416
Country : US
Telephone Number : 907-966-2411
Fax Number : 907-966-8606
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/23/2005
Last Update Date : 04/22/2010

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Directions to “ DR. JOHN A BACIOCCO MD” Practice Location

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