Provider Demographics
NPI:1992129043
Name:OTCHERE, BAFFOUR
Entity type:Individual
Prefix:
First Name:BAFFOUR
Middle Name:
Last Name:OTCHERE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 11369
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45211
Mailing Address - Country:US
Mailing Address - Phone:513-259-5308
Mailing Address - Fax:513-598-9397
Practice Address - Street 1:5601 OPENGATE CT
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45247
Practice Address - Country:US
Practice Address - Phone:513-259-5308
Practice Address - Fax:513-598-9397
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker