Bautista, Mario

Bautista, Mario is an individual health care provider with primary practice located at 1000 Veterans Dr , Jackson OH 45640-9586. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Bautista, Mario can be contacted via phone (740) 395-8090.

Contact Information

Primary practice address
1000 Veterans Dr Jackson OH 45640-9586
Phone: (740) 395-8090
Fax: (740) 395-8197
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 2004-0547 New Mexico
Allopathic & Osteopathic Physicians / Pediatric Emergency Medicine 2080P0204X 2004-0547 New Mexico
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35.089012 Ohio

Profile Details

NPI number 1619955192
LBN Legal business name Bautista, Mario
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2006
Last updated Nov 25th, 2020 - about 4 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 1619955192 NPPES
New Mexico Other 10016535 LOVELACE HEALTH/SALUD
New Mexico Other P00137209 LOVELACE HEALTH/SALUD
New Mexico Other PROVP11655 LOVELACE HEALTH/SALUD
New Mexico Other 201047701 LOVELACE HEALTH/SALUD
New Mexico MEDICAID 2711211 LOVELACE HEALTH/SALUD
New Mexico Other 885808 LOVELACE HEALTH/SALUD
New Mexico MEDICAID 99238071 LOVELACE HEALTH/SALUD
New Mexico Other NM009R63 LOVELACE HEALTH/SALUD

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