Provider Demographics
NPI:1679623854
Name:ESARCO, JOHN ALLAN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ALLAN
Last Name:ESARCO
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7505 CALIFORNIA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BOARDMAN
Mailing Address - State:OH
Mailing Address - Zip Code:44512-5618
Mailing Address - Country:US
Mailing Address - Phone:330-758-1599
Mailing Address - Fax:330-758-6053
Practice Address - Street 1:7505 CALIFORNIA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BOARDMAN
Practice Address - State:OH
Practice Address - Zip Code:44512-5618
Practice Address - Country:US
Practice Address - Phone:330-758-1599
Practice Address - Fax:330-758-6053
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH596111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0335739Medicaid
OH341214547-00OtherWORKERS COMPENSATION
OH411591944OtherMAIL HANDLERS
OH34-1214547OtherCOMMERCIAL INSURANCE
OH44-00180OtherUNITED
OH000000480608OtherANTHEM
OHT46854Medicare UPIN
OH34-1214547OtherCOMMERCIAL INSURANCE