Provider Demographics
NPI:1316093412
Name:BAX, JOSEPH A (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:BAX
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:700 PARK PL
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14301-1028
Mailing Address - Country:US
Mailing Address - Phone:716-285-7366
Mailing Address - Fax:716-285-2580
Practice Address - Street 1:700 PARK PL
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14301-1028
Practice Address - Country:US
Practice Address - Phone:716-285-7366
Practice Address - Fax:716-285-2580
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2014-01-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY143785-1207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYD01426Medicare UPIN