Provider Demographics
NPI:1073794723
Name:JAMES B KAHL MD
Entity Type:Organization
Organization Name:JAMES B KAHL MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:B
Authorized Official - Last Name:KAHL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:513-984-2777
Mailing Address - Street 1:7770 COOPER RD
Mailing Address - Street 2:SUITE 10
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45242-7727
Mailing Address - Country:US
Mailing Address - Phone:513-984-2777
Mailing Address - Fax:513-984-4628
Practice Address - Street 1:7770 COOPER RD
Practice Address - Street 2:SUITE 10
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45242-7727
Practice Address - Country:US
Practice Address - Phone:513-984-2777
Practice Address - Fax:513-984-4628
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-23
Last Update Date:2007-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35027908208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0105933Medicaid
OHSP05171Medicare PIN
OH0105933Medicaid