Baccus, Grady K
Baccus, Grady K is an sole proprietor health care provider with primary practice located at 2021 E Dublin Granville Rd Suite 169, Columbus OH 43229-3568. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Baccus, Grady K can be contacted via phone (614) 888-5133.Contact Information
Primary practice address
2021 E Dublin Granville Rd Suite 169
Columbus OH 43229-3568
Phone: (614) 888-5133
Fax: (614) 888-8331
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 4269 | Ohio |
Profile Details
| NPI number | 1811097561 |
|---|---|
| LBN Legal business name | Baccus, Grady K |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 23rd, 2006 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1811097561 | NPPES |
| Ohio | MEDICAID | 0819547 |
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