Provider Demographics
NPI:1710340427
Name:PIAZZA, KATHLEEN RUTH (DO)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:RUTH
Last Name:PIAZZA
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KATHLEEN
Other - Middle Name:RUTH
Other - Last Name:STOVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 636388
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-6388
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:419-251-6849
Practice Address - Street 1:4126 N HOLLAND SYLVANIA RD STE 220
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43623-3537
Practice Address - Country:US
Practice Address - Phone:419-517-7665
Practice Address - Fax:419-517-7598
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.014435207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology