NPI 1619955192 · live from the CMS NPI Registry
Mario Bautista, MD
Pediatrics in Jackson, OH. National Provider Identifier 1619955192, active.
NPI record
| NPI | 1619955192 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Pediatrics 208000000X |
| Practice location | 1000 Veterans Dr, Jackson, OH 45640 |
| Practice phone | 740-395-8090 |
| Mailing address | 272 Hospital Rd Ste 6, Chillicothe, OH 45601 |
| Enumerated | January 5, 2006 |
| Last updated | November 25, 2020 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatrics | 208000000X | 2004-0547 (NM) |
| Pediatrics, Pediatric Emergency Medicine | 2080P0204X | 2004-0547 (NM) |
| Pediatrics primary | 208000000X | 35.089012 (OH) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.