Bacon, John Richard

Bacon, John Richard is an sole proprietor health care provider with primary practice located at 120 Sister Pierre Dr Ste 201, Towson MD 21204-7525. He recently has only one registered license in Allopathic & Osteopathic Physicians / Allergy, which is considered as his primary health care specialty. Bacon, John Richard can be contacted via phone (410) 321-0284.

Contact Information

Primary practice address
120 Sister Pierre Dr Ste 201 Towson MD 21204-7525
Fax: (410) 321-0286
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Allergy 207KA0200X D0028727 Maryland

Profile Details

NPI number 1538162078
LBN Legal business name Bacon, John Richard
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 28th, 2005
Last updated May 19th, 2010 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1538162078 NPPES
Maryland MEDICAID 26692-1800

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