Provider Demographics
NPI:1598722068
Name:KAVLE, EDWARD CARLTON (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:CARLTON
Last Name:KAVLE
Suffix:
Gender:M
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:PO BOX 1021
Mailing Address - Street 2:
Mailing Address - City:LITCHFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06759-1021
Mailing Address - Country:US
Mailing Address - Phone:860-567-0054
Mailing Address - Fax:
Practice Address - Street 1:538 LITCHFIELD ST
Practice Address - Street 2:SUITE G-02
Practice Address - City:TORRINGTON
Practice Address - State:CT
Practice Address - Zip Code:06790-6669
Practice Address - Country:US
Practice Address - Phone:860-489-5068
Practice Address - Fax:860-489-3725
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0333862080A0000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics