Provider Demographics
NPI:1275840381
Name:JANET R N KAIL DPM
Entity Type:Organization
Organization Name:JANET R N KAIL DPM
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:RN
Authorized Official - Last Name:KAIL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:937-878-2800
Mailing Address - Street 1:402 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:FAIRBORN
Mailing Address - State:OH
Mailing Address - Zip Code:45324-4817
Mailing Address - Country:US
Mailing Address - Phone:937-878-2800
Mailing Address - Fax:937-878-7261
Practice Address - Street 1:402 W MAIN ST
Practice Address - Street 2:
Practice Address - City:FAIRBORN
Practice Address - State:OH
Practice Address - Zip Code:45324-4817
Practice Address - Country:US
Practice Address - Phone:937-878-2800
Practice Address - Fax:937-878-7261
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-10
Last Update Date:2011-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH360002830213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0777539Medicare PIN