Provider Demographics
NPI:1437195229
Name:R DONTHI MD & ASSOC INC
Entity Type:Organization
Organization Name:R DONTHI MD & ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KIRAN
Authorized Official - Middle Name:R
Authorized Official - Last Name:DONTHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-923-5123
Mailing Address - Street 1:275 GRAHAM RD
Mailing Address - Street 2:STE #2
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44223-2259
Mailing Address - Country:US
Mailing Address - Phone:330-923-5123
Mailing Address - Fax:330-923-6654
Practice Address - Street 1:275 GRAHAM RD
Practice Address - Street 2:STE #2
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44223-2259
Practice Address - Country:US
Practice Address - Phone:330-923-5123
Practice Address - Fax:330-923-6654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2010-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0475972Medicaid
D00482542OtherMEDICARE PIN
OH0417454Medicaid
A79625Medicare UPIN
OH0417454Medicaid