Provider Demographics
NPI:1275567885
Name:CINGLE, KIMBERLY ANN (MD)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:ANN
Last Name:CINGLE
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 1:2013 STATE ROUTE 59
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:OH
Mailing Address - Zip Code:44240-4113
Mailing Address - Country:US
Mailing Address - Phone:330-678-0201
Mailing Address - Fax:330-678-4272
Practice Address - Street 1:2013 STATE ROUTE 59
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-4113
Practice Address - Country:US
Practice Address - Phone:330-678-0201
Practice Address - Fax:330-678-4272
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2013-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-5779207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH800519742051OtherCARE SOURCE
OH5683020001OtherD M E R C /MEDICARE
OH2603418Medicaid
OH3053574Medicaid
OH000000374414OtherUNICARE
OH000000656336OtherANTHEM BLUECROSS
OH0878449Medicare PIN
OH2603418Medicaid