Provider Demographics
NPI:1104236488
Name:JAYKEL, MATTHEW NICHOLAS (MD)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:NICHOLAS
Last Name:JAYKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PARK WEST BLVD STE 330
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44320-4226
Mailing Address - Country:US
Mailing Address - Phone:330-835-5533
Mailing Address - Fax:
Practice Address - Street 1:1 PARK WEST BLVD STE 330
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44320-4226
Practice Address - Country:US
Practice Address - Phone:330-835-5533
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-07
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.138695207XS0117X
MI4301105000390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine