Provider Demographics
NPI:1972562619
Name:LAIKOS, GEORGE DEMETRIOS (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:DEMETRIOS
Last Name:LAIKOS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1232 BUCHHOLZER BLVD
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-5179
Mailing Address - Country:US
Mailing Address - Phone:330-928-8700
Mailing Address - Fax:330-928-5331
Practice Address - Street 1:1232 BUCHHOLZER BLVD
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-5179
Practice Address - Country:US
Practice Address - Phone:330-928-8700
Practice Address - Fax:330-928-5331
Is Sole Proprietor?:No
Enumeration Date:2006-03-21
Last Update Date:2012-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-059998207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH04-03135OtherUNITED HEALTHCARE
OH108OtherSUMMA
OH000000132162OtherANTHEM
OH0851770Medicaid
OH729758OtherBUCKEYE COMMUNITY HEALTH
OHLA0693144OtherMEDICARE ID
OH047585OtherSELECT CARE
OH05N26OtherEMERALD
OH0693146OtherMEDICARE ID
OHP00097574OtherRAILROAD MEDICARE
OH0851770Medicaid