Provider Demographics
NPI:1770525727
Name:KITSON, PATRICIA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:ANN
Last Name:KITSON
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 1:615 MESSINA DR
Mailing Address - Street 2:
Mailing Address - City:WADSWORTH
Mailing Address - State:OH
Mailing Address - Zip Code:44281-8585
Mailing Address - Country:US
Mailing Address - Phone:330-239-2719
Mailing Address - Fax:
Practice Address - Street 1:605 N CLEVELAND MASSILLON RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44333-2241
Practice Address - Country:US
Practice Address - Phone:330-666-3333
Practice Address - Fax:330-668-6532
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2011-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35048079207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
0541265OtherMEDICARE ID
IR0541261OtherMEDICARE ID
OH0598278Medicaid
IR0541261OtherMEDICARE ID