MEDICARE: DR. GRADY K BACCUS PH.D.

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	103TC0700X	Clinical Psychologist	4269	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1811097561
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GRADY K BACCUS PH.D.

Provider Business Mailing Address
First Line	:	2021 E DUBLIN GRANVILLE RD
Second Line	:	SUITE 169
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3568
Country	:	US
Telephone Number	:	614-888-5133
Fax Number	:	614-888-8331

Provider Business Practice Location Address
First Line	:	2021 E DUBLIN GRANVILLE RD
Second Line	:	SUITE 169
City	:	COLUMBUS
State	:	OH
Zip	:	43229-3568
Country	:	US
Telephone Number	:	614-888-5133
Fax Number	:	614-888-8331

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

Provider Enumeration Date	:	09/23/2006
Last Update Date	:	07/09/2007

Similar Medicare Providers

1528913175 — RIDE EXCELLENCE LLC
Practice Location Address:

2021 E DUBLIN GRANVILLE RD # 216
COLUMBUS, OH
43229-3568

Practice Phone: 614-561-9206
Practice Fax:

1558308973 — JAMA & SULUB HOME HEALTH CARE, LLC
Practice Location Address:

2021 E DUBLIN GRANVILLE RD , SUITE 185
COLUMBUS, OH
43229-3568

Practice Phone: 614-430-8040
Practice Fax: 614-430-8070

1679504401 — LIVING-WATER HEALTHCARE SERVICES LLC.
Practice Location Address:

2021 E DUBLIN GRANVILLE RD , 256
COLUMBUS, OH
43229-3568

Practice Phone: 614-596-4626
Practice Fax:

1376672071 — DR. KABIN J CARDER DC
Practice Location Address:

2021 E DUBLIN GRANVILLE RD , STE 145
COLUMBUS, OH
43229-3568

Practice Phone: 614-888-9655
Practice Fax: 614-888-9663

1952524068 — CITY HOME HEALTH CARE INC
Practice Location Address:

2021 E DUBLIN GRANVILLE RD
COLUMBUS, OH
43229-3568

Practice Phone: 614-430-8740
Practice Fax: 614-372-8091

1588858872 — DHULMAR TRANSPORTATION
Practice Location Address:

2021 E DUBLIN GRANVILLE RD , SUITE 185
COLUMBUS, OH
43229-3568

Practice Phone: 614-436-3900
Practice Fax:

Directions to “ DR. GRADY K BACCUS PH.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.