Provider Demographics
NPI:1346373024
Name:SETH, KIMBERLY JO (MD)
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:JO
Last Name:SETH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:1580 YORKSHIRE TRCE SE
Mailing Address - Street 2:
Mailing Address - City:NORTH CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44709-4854
Mailing Address - Country:US
Mailing Address - Phone:330-966-3107
Mailing Address - Fax:
Practice Address - Street 1:3730 WHIPPLE AVE NW
Practice Address - Street 2:SUITE 400
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-4803
Practice Address - Country:US
Practice Address - Phone:330-491-9675
Practice Address - Fax:330-491-1682
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-07-9184S207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine