Provider Demographics
NPI:1881833887
Name:KERTH, JEFF CARL
Entity Type:Individual
Prefix:MR
First Name:JEFF
Middle Name:CARL
Last Name:KERTH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:OH
Mailing Address - Zip Code:45030-1210
Mailing Address - Country:US
Mailing Address - Phone:513-236-6500
Mailing Address - Fax:513-202-1371
Practice Address - Street 1:307 N ELM ST
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-1210
Practice Address - Country:US
Practice Address - Phone:513-236-6500
Practice Address - Fax:513-202-1371
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-13
Last Update Date:2009-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications