Healthcare Provider Details

I. General information

NPI: 1881223006
Provider Name (Legal Business Name): KEVIN ANTHONY VENCZEL DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2020
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E MARKET ST
AKRON OH
44304-1619
US

IV. Provider business mailing address

525 E MARKET ST
AKRON OH
44304-1619
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3361
  • Fax: 330-375-7415
Mailing address:
  • Phone: 330-375-3361
  • Fax: 330-375-7415

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number34.016152
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number34.016152
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: