Provider Demographics
NPI:1457896201
Name:BAKAYSA, ALEXANDER RAYMOND (DC)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:RAYMOND
Last Name:BAKAYSA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:785 LUXURY LN
Mailing Address - Street 2:APARTMENT C
Mailing Address - City:ASHEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27205-8936
Mailing Address - Country:US
Mailing Address - Phone:814-952-4852
Mailing Address - Fax:
Practice Address - Street 1:177 NC HIGHWAY 42 N
Practice Address - Street 2:
Practice Address - City:ASHEBORO
Practice Address - State:NC
Practice Address - Zip Code:27203-7967
Practice Address - Country:US
Practice Address - Phone:336-625-1750
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-04
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4702111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor