Provider Demographics
NPI:1568465011
Name:JACOB DAGANI, M.D.
Entity Type:Organization
Organization Name:JACOB DAGANI, M.D.
Other - Org Name:BLUFFTON WOMEN'S CARE, LLC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JACOB
Authorized Official - Middle Name:
Authorized Official - Last Name:DAGANI
Authorized Official - Suffix:
Authorized Official - Credentials:M D
Authorized Official - Phone:419-358-8856
Mailing Address - Street 1:PO BOX 207
Mailing Address - Street 2:
Mailing Address - City:BLUFFTON
Mailing Address - State:OH
Mailing Address - Zip Code:45817-0207
Mailing Address - Country:US
Mailing Address - Phone:419-358-8856
Mailing Address - Fax:419-358-6780
Practice Address - Street 1:559 HARMON RD
Practice Address - Street 2:
Practice Address - City:BLUFFTON
Practice Address - State:OH
Practice Address - Zip Code:45817-1070
Practice Address - Country:US
Practice Address - Phone:419-358-8856
Practice Address - Fax:419-358-6780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.063339207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH411862313004OtherMEDICAL MUTUAL OF OHIO
OH4247157OtherAETNA
OH0874479Medicaid
OH411862313004OtherMEDICAL MUTUAL OF OHIO
OH4247157OtherAETNA
OH0718033Medicare ID - Type Unspecified