Provider Demographics
NPI:1891865390
Name:JAMES A BAUER DC INC
Entity Type:Organization
Organization Name:JAMES A BAUER DC INC
Other - Org Name:BAUER CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:ALBIN
Authorized Official - Last Name:BAUER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:419-782-1166
Mailing Address - Street 1:619 W SECOND STREET
Mailing Address - Street 2:
Mailing Address - City:DEFIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:43512-2104
Mailing Address - Country:US
Mailing Address - Phone:419-782-1166
Mailing Address - Fax:
Practice Address - Street 1:619 W SECOND STREET
Practice Address - Street 2:
Practice Address - City:DEFIANCE
Practice Address - State:OH
Practice Address - Zip Code:43512-2104
Practice Address - Country:US
Practice Address - Phone:419-782-1166
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH830111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0446584Medicaid
9271151OtherMEDICARE GROUP #
T47339Medicare UPIN
OH0446584Medicaid