Healthcare Provider Details

I. General information

NPI: 1124084959
Provider Name (Legal Business Name): VASANTHA KUTHALINGAM KUMAR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/21/2006
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 MERCY DR NW
CANTON OH
44708-2614
US

IV. Provider business mailing address

90 JACKSON PIKE
GALLIPOLIS OH
45631-1562
US

V. Phone/Fax

Practice location:
  • Phone: 330-489-1478
  • Fax: 330-430-2717
Mailing address:
  • Phone: 740-446-5387
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number35075830
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number01056949A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: