Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 34002308A | OH |
NPI | 1003819202 |
---|---|
Provider Name | Jeffrey M Ayers |
First Address | Lancaster, OH 43130-4056 |
Second Address | Lancaster, OH 43130-4056 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 18/04/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0271389 | (05) | OH |
A75050 | (02) | OH |
CD3781 | MEDICARE RAILROAD (01) | OH |