Provider Demographics
NPI:1205908647
Name:KEMMLER ORTHOPAEDIC CENTER, INC
Entity type:Organization
Organization Name:KEMMLER ORTHOPAEDIC CENTER, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NINA
Authorized Official - Middle Name:L
Authorized Official - Last Name:VANARSDEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:419-586-5760
Mailing Address - Street 1:123 HAMILTON ST
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:OH
Mailing Address - Zip Code:45822-1909
Mailing Address - Country:US
Mailing Address - Phone:419-586-5760
Mailing Address - Fax:419-586-1257
Practice Address - Street 1:123 HAMILTON ST
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:OH
Practice Address - Zip Code:45822-1909
Practice Address - Country:US
Practice Address - Phone:419-586-5760
Practice Address - Fax:419-586-1257
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-14
Last Update Date:2010-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2581693Medicaid
OH2581693Medicaid
OH2581693Medicaid
OH5313520001Medicare NSC
OH=========00OtherBWC