Provider Demographics
NPI:1699814863
Name:WILLIAM J BAJOREK DO INC
Entity Type:Organization
Organization Name:WILLIAM J BAJOREK DO INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:BAJOREK
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:513-553-3288
Mailing Address - Street 1:1471 FRANK WILLIS MEML RD
Mailing Address - Street 2:
Mailing Address - City:NEW RICHMOND
Mailing Address - State:OH
Mailing Address - Zip Code:45157-8657
Mailing Address - Country:US
Mailing Address - Phone:543-553-3288
Mailing Address - Fax:513-553-2928
Practice Address - Street 1:1325 E KEMPER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SPRINGDALE
Practice Address - State:OH
Practice Address - Zip Code:45246-3903
Practice Address - Country:US
Practice Address - Phone:513-671-7246
Practice Address - Fax:513-671-4786
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2011-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34-00-3487208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty