Provider Demographics
NPI:1205845526
Name:JANE-WIT, KANTIMA C (MD)
Entity Type:Individual
Prefix:DR
First Name:KANTIMA
Middle Name:C
Last Name:JANE-WIT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 HOSPITAL RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHILLICOTHE
Mailing Address - State:OH
Mailing Address - Zip Code:45601-9031
Mailing Address - Country:US
Mailing Address - Phone:740-779-4300
Mailing Address - Fax:740-779-4300
Practice Address - Street 1:4439 STATE ROUTE 159
Practice Address - Street 2:SUITE G10
Practice Address - City:CHILLICOTHE
Practice Address - State:OH
Practice Address - Zip Code:45601-8207
Practice Address - Country:US
Practice Address - Phone:740-779-4300
Practice Address - Fax:740-779-4391
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2012-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-0935208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0372556Medicaid