Provider Demographics
NPI:1467653584
Name:PAQUIN, JASON (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:PAQUIN
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 1:7502 STATE ROAD
Mailing Address - Street 2:MEDICAL OFFICE BUILDING, SUITE 2210
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45255-2800
Mailing Address - Country:US
Mailing Address - Phone:513-624-2070
Mailing Address - Fax:513-624-2077
Practice Address - Street 1:7675 WELLNESS WAY
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2509
Practice Address - Country:US
Practice Address - Phone:513-475-8521
Practice Address - Fax:513-475-7480
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-29
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.092602207RC0000X, 207RI0011X
OH35092602207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0086943Medicaid