Provider Demographics
NPI:1639151806
Name:DONALD KIKTA M.D., INC.
Entity Type:Organization
Organization Name:DONALD KIKTA M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DONALD
Authorized Official - Middle Name:GREGORY
Authorized Official - Last Name:KIKTA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:440-884-1166
Mailing Address - Street 1:6681 RIDGE RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:PARMA
Mailing Address - State:OH
Mailing Address - Zip Code:44129-5713
Mailing Address - Country:US
Mailing Address - Phone:440-884-1166
Mailing Address - Fax:440-884-1150
Practice Address - Street 1:6681 RIDGE RD
Practice Address - Street 2:SUITE 310
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-5713
Practice Address - Country:US
Practice Address - Phone:440-884-1166
Practice Address - Fax:440-884-1150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-15
Last Update Date:2008-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH350397672084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2809303Medicaid
OHA79788Medicare UPIN
OHDO0882381Medicare ID - Type Unspecified