Healthcare Provider Details

I. General information

NPI: 1467491654
Provider Name (Legal Business Name): KIRK STIFFLER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 01/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E MARKET ST
AKRON OH
44304-1619
US

IV. Provider business mailing address

PO BOX 1649
AKRON OH
44309-1649
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3369
  • Fax: 330-375-3769
Mailing address:
  • Phone: 330-864-8900
  • Fax: 330-869-8924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number350691935
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: