Provider Demographics
NPI:1659892719
Name:KANE, EMILY WESSON (MD)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:WESSON
Last Name:KANE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:604 DAVIS CIR SW
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5014
Mailing Address - Country:US
Mailing Address - Phone:256-634-6932
Mailing Address - Fax:256-290-7351
Practice Address - Street 1:10524 EUCLID AVE STE 8107
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44106-2205
Practice Address - Country:US
Practice Address - Phone:216-844-3658
Practice Address - Fax:216-844-4741
Is Sole Proprietor?:No
Enumeration Date:2017-06-29
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL51246208000000X
OH35.1390162084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No208000000XAllopathic & Osteopathic PhysiciansPediatrics