Provider Demographics
NPI:1710974043
Name:KEGLER, KEVIN G (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:G
Last Name:KEGLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3535 FISHINGER BLVD
Mailing Address - Street 2:SUITE 230
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7504
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3535 FISHINGER BLVD
Practice Address - Street 2:SUITE 230
Practice Address - City:HILLIARD
Practice Address - State:OH
Practice Address - Zip Code:43026-7504
Practice Address - Country:US
Practice Address - Phone:614-777-3937
Practice Address - Fax:614-777-4190
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2020-10-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35078913K207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2305642Medicaid
OH9347754Medicare PIN
OHH33592Medicare UPIN
OH2305642Medicaid