Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 35050538K | OH |
NPI | 1053315747 |
---|---|
Provider Name | David J Kissel |
First Address | Cincinnati, OH 45242-0461 |
Second Address | Cincinnati, OH 45242-5862 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/06/2005 |
Last Update Date | 25/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0584765 | (05) | OH |
64934755 | (05) | KY |
E77878 | (02) | OH |