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NPI Code Detail

MEDICARE: MR. STEPHEN BAKSAY P.T.

MEDICARE: MR. STEPHEN BAKSAY P.T.
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
1225100000XPhysical Therapist2573OR

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3650017555OTHERORMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1067873002OTHERORBLUE CROSS OF OREGON
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4J284201OTHERORPACIFIC SOURCE INSURANCE

General Provider Information

NPI Number : 1366442352
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. STEPHEN BAKSAY P.T.
Provider Business Mailing Address
First Line : 2780 E BARNETT RD STE 200
Second Line :
City : MEDFORD
State : OR
Zip : 97504-8674
Country : US
Telephone Number : 541-779-6250
Fax Number :
Provider Business Practice Location Address
First Line : 2780 E BARNETT RD STE 200
Second Line :
City : MEDFORD
State : OR
Zip : 97504-8674
Country : US
Telephone Number : 541-779-6250
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/31/2005
Last Update Date : 05/02/2025

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Directions to “ MR. STEPHEN BAKSAY P.T.” Practice Location

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