Provider Demographics
NPI:1497798151
Name:BAFFORD, DAVID PAUL (DO)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:PAUL
Last Name:BAFFORD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3927 S ASHLEAF LN
Mailing Address - Street 2:
Mailing Address - City:BEAVERCREEK
Mailing Address - State:OH
Mailing Address - Zip Code:45440-5105
Mailing Address - Country:US
Mailing Address - Phone:937-426-0029
Mailing Address - Fax:
Practice Address - Street 1:1001 BELLEFONTAINE AVE
Practice Address - Street 2:
Practice Address - City:LIMA
Practice Address - State:OH
Practice Address - Zip Code:45804-2800
Practice Address - Country:US
Practice Address - Phone:419-228-3335
Practice Address - Fax:419-226-5113
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2009-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA053666207P00000X
OH34.007602207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000527458OtherANTHEM BCBS
GA447822139BMedicaid
OH2262171Medicaid
OH4057274Medicare PIN
OHP00404494Medicare PIN
GAH44450Medicare UPIN
OHBA4057273Medicare PIN
GA447822139BMedicaid