Robert a Bazylak, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD014601E Issued in PA

Legal business name

ROBERT A BAZYLAK, M.D.

Practice address

12387 Conneaut Lake Rd
Conneaut Lake, PA 16316-4203

Phone

(814) 382-0221

Fax

(814) 382-0231

NPI assigned

Jan 16, 2017

Organization subpart

Yes

Parent organization

FRENCH CREEK INTERNAL MEDICINEAs reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christian Miles

Title

Vice President, Physician Services

Phone

(814) 333-5267

Specialties & licenses 1

Addresses

Tax ID family

Primary Care Services2 organizations share this tax ID, including this one

Part of

Primary Care Services

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• French Creek Internal Medicine

  • Non-Pharmacy Dispensing Site
  • Meadville, PA
  • NPI 1750572467
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1484524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1484524800000",
    "number": "1306382270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1034 GROVE ST",
            "city": "MEADVILLE",
            "state": "PA",
            "postal_code": "163352945",
            "telephone_number": "814-382-0221",
            "fax_number": "814-382-0231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12387 CONNEAUT LAKE RD",
            "city": "CONNEAUT LAKE",
            "state": "PA",
            "postal_code": "163164203",
            "telephone_number": "814-382-0221",
            "fax_number": "814-382-0231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROBERT A BAZYLAK, M.D.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FRENCH CREEK INTERNAL MEDICINE",
        "enumeration_date": "2017-01-16",
        "last_updated": "2017-01-16",
        "status": "A",
        "authorized_official_last_name": "MILES",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_title_or_position": "VICE PRESIDENT, PHYSICIAN SERVICES",
        "authorized_official_telephone_number": "814-333-5267"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD014601E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Candyce A. Lucian, D.O.
• Kaelyn R Mitchell, CRNP
• Trish Lynn Mook, LCSW
• Professional Counseling and Consulting Services Inc
• Rising Phoenix Mental Wellness, PLLC
• Cammie Sands, CCC-SLP
• Aubrey Linn Saunier
• Andrew Joseph Schlosser, DPT
• Randall B. Schlosser, P.T.
• Lacey Stoner, OTR/L

• Family Medicine Physician in Conneaut Lake, PA
• Providers in Conneaut Lake, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.