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KATHRYN E. BOEHM MD LLC NPI 1104052844


NPI Information

NPI: 1104052844
Provider Name: KATHRYN E. BOEHM, MD, LLC
Classification: Clinic/Center - 261Q00000X
Entity Type: Organization
Address:
3454 OAK ALLEY CT
SUITE 210
TOLEDO, OH
ZIP 43606
Phone: (419) 724-6888
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KATHRYN E. BOEHM, MD, LLC is a clinic center in Toledo, OH. The provider is a facility or distinct part of one used for the diagnosis and treatment of outpatients. Clinic/Center is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). KATHRYN E. BOEHM, MD, LLC NPI is 1104052844. The provider is registered as an organization entity type.

The provider's business location address is:

3454 OAK ALLEY CT
SUITE 210
TOLEDO, OH
ZIP 43606-306
Phone: (419) 724-6888
Fax: (419) 724-6893

The provider's authorized official is Kathryn Elaine Boehm .
The authorized official title is Sole Proprietor and has the following contact phone number (419) 724-6888.

The enumeration date for this NPI number is 6/9/2009 and was last updated on 12/23/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261Q00000XClinic/Center35056573BOHIOYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
19347012OTHERMEDICARE PTAN GROUP #
2KA9347011OTHEROHIOMEDICARE PTAN GROUP #
33159862OTHEROHIOMEDICAID GROUP NUMBER
40744430MEDICAIDOHIO

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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