MEDICARE: DR. JACOB ALEXANDER BAIR D.O.

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
1	207Q00000X	Family Medicine Physician	34.011557	OH

General Provider Information

NPI Number	:	1346597523
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JACOB ALEXANDER BAIR D.O.

Provider Business Mailing Address
First Line	:	8700 E MARKET ST
Second Line	:	SUITE 4
City	:	WARREN
State	:	OH
Zip	:	44484-2340
Country	:	US
Telephone Number	:	330-856-1035
Fax Number	:	330-856-6500

Provider Business Practice Location Address
First Line	:	8700 E MARKET ST
Second Line	:	SUITE 4
City	:	WARREN
State	:	OH
Zip	:	44484-2340
Country	:	US
Telephone Number	:	330-856-1035
Fax Number	:	330-856-6500

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2012
Last Update Date	:	12/16/2024

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