Provider Demographics
NPI:1902830573
Name:RESCH, JEFFREY D (DO)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:D
Last Name:RESCH
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 1:20 OHLTOWN RD
Mailing Address - Street 2:
Mailing Address - City:YOUNGSTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44515-2331
Mailing Address - Country:US
Mailing Address - Phone:330-797-9705
Mailing Address - Fax:330-270-5997
Practice Address - Street 1:20 OHLTOWN RD
Practice Address - Street 2:
Practice Address - City:YOUNGSTOWN
Practice Address - State:OH
Practice Address - Zip Code:44515-2331
Practice Address - Country:US
Practice Address - Phone:330-797-9705
Practice Address - Fax:330-270-5997
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34003213207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000243208OtherANTHEM BC/BS
OH402908OtherUNITED HEALTHCARE
OHZ03213OtherSUMMACARE
OHQ003974OtherHOMETOWN
OH78910OtherHEALTH ASSURANCE
OH0631614Medicaid
OH341341025043OtherCARESOURCE
OHZ03213OtherSUMMACARE
OH78910OtherHEALTH ASSURANCE
OH0631614Medicaid
OH341341025043OtherCARESOURCE
OH$$$$$$$$$006OtherMEDICAL MUTUAL OF OHIO