MEDICARE: DR. JOHN F KUNKEL D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	36-00-2744-K	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	480016576	OTHER	OH	MEDICARE RAILROAD PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1457399222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN F KUNKEL D.P.M.

Provider Business Mailing Address
First Line	:	PO BOX 40450
Second Line	:
City	:	BAY VILLAGE
State	:	OH
Zip	:	44140-0450
Country	:	US
Telephone Number	:	440-871-4700
Fax Number	:	440-871-4702

Provider Business Practice Location Address
First Line	:	518 GLACIER HEIGHTS RD
Second Line	:
City	:	YOUNGSTOWN
State	:	OH
Zip	:	44509-1920
Country	:	US
Telephone Number	:	330-507-7999
Fax Number	:	330-792-6309

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	06/25/2010

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