Provider Demographics
NPI:1962483842
Name:MINIER, JAYNE A (MD)
Entity Type:Individual
Prefix:
First Name:JAYNE
Middle Name:A
Last Name:MINIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 BENEDICT AVE
Mailing Address - Street 2:SUITE 800
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2721
Mailing Address - Country:US
Mailing Address - Phone:419-668-5222
Mailing Address - Fax:419-668-5251
Practice Address - Street 1:278 BENEDICT AVE
Practice Address - Street 2:SUITE 800
Practice Address - City:NORWALK
Practice Address - State:OH
Practice Address - Zip Code:44857-2721
Practice Address - Country:US
Practice Address - Phone:419-668-5222
Practice Address - Fax:419-668-5251
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2009-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH65639208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000121932OtherANTHEM
OH0933191Medicaid
OH020038039OtherRAILROAD MEDICARE
OH4263482OtherAETNA
OH124594500OtherFEDERAL WORKMANS COMP
OH1342608OtherFIRST HEALTH
OH311571453004OtherCIGNA
OH1342608OtherFIRST HEALTH
OH311571453004OtherCIGNA