Provider Demographics
NPI:1467495341
Name:BHASKARAN, JAYAPANDIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JAYAPANDIAN
Middle Name:
Last Name:BHASKARAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 636745
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263
Mailing Address - Country:US
Mailing Address - Phone:513-451-4033
Mailing Address - Fax:513-451-4118
Practice Address - Street 1:5520 CHEVIOT ROAD
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247
Practice Address - Country:US
Practice Address - Phone:513-451-4033
Practice Address - Fax:513-451-4118
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2012-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-042128207RX0202X, 207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0377202Medicaid
OH2694197Medicaid
OH2694197Medicaid
OH0457638Medicare PIN
OH0377202Medicaid
4199073Medicare PIN
OH0457639Medicare PIN