Provider Demographics
NPI:1922736511
Name:BAITY, JASON CHARLES (CP)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:CHARLES
Last Name:BAITY
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4026 QUAIL HIGH BLVD
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27560-7022
Mailing Address - Country:US
Mailing Address - Phone:336-775-7233
Mailing Address - Fax:
Practice Address - Street 1:4702 CREEKSTONE DR
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27703-8410
Practice Address - Country:US
Practice Address - Phone:919-797-1230
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-11
Last Update Date:2022-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCP004310224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist