MEDICARE: MARK T JAROCH M.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	208600000X	Surgery Physician	35-055029	OH
2	208600000X	Surgery Physician	4301084587	MI

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	:	1932209418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK T JAROCH M.D.

Provider Business Mailing Address
First Line	:	1261 WOOSTER RD
Second Line	:	SUITE 200
City	:	MILLERSBURG
State	:	OH
Zip	:	44654-1568
Country	:	US
Telephone Number	:	330-763-2018
Fax Number	:	330-674-9706

Provider Business Practice Location Address
First Line	:	1261 WOOSTER RD
Second Line	:	SUITE 200
City	:	MILLERSBURG
State	:	OH
Zip	:	44654-1568
Country	:	US
Telephone Number	:	330-763-2018
Fax Number	:	330-674-9706

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

Provider Enumeration Date	:	09/24/2006
Last Update Date	:	03/26/2018

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