Provider Demographics
NPI:1467642488
Name:JON BAFFORD CHIROPRACTIC INC.
Entity type:Organization
Organization Name:JON BAFFORD CHIROPRACTIC INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:BAFFORD
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:740-366-5599
Mailing Address - Street 1:843 N 21ST ST STE 102C
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:OH
Mailing Address - Zip Code:43055-7274
Mailing Address - Country:US
Mailing Address - Phone:740-366-5599
Mailing Address - Fax:740-366-8051
Practice Address - Street 1:843 N 21ST ST STE 102C
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:OH
Practice Address - Zip Code:43055-7274
Practice Address - Country:US
Practice Address - Phone:740-366-5599
Practice Address - Fax:740-366-8051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2007-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2951111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1073611182OtherNPI
OH2169175Medicaid
OH2169175Medicaid
1073611182OtherNPI