Basic Information
| Provider Information | |||||||||
| NPI: | 1043469356 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BALCOM | ||||||||
| FirstName: | JOEL | ||||||||
| MiddleName: | ERIC | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3125 DUNBARTON AVE NW | ||||||||
| Address2: | |||||||||
| City: | CANTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 447081844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3306143606 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 200 E STATE ST | ||||||||
| Address2: | |||||||||
| City: | ALLIANCE | ||||||||
| State: | OH | ||||||||
| PostalCode: | 446014936 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3305966100 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/10/2008 | ||||||||
| LastUpdateDate: | 08/29/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 08/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | MT188804 | PA | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 207P00000X | 35.093250 | OH | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.