Healthcare Provider Details

I. General information

NPI: 1740274117
Provider Name (Legal Business Name): DAVID L KIRLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 09/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4350 MALSBARY RD
CINCINNATI OH
45242-5621
US

IV. Provider business mailing address

5053 WOOSTER RD
CINCINNATI OH
45226-2326
US

V. Phone/Fax

Practice location:
  • Phone: 513-751-2273
  • Fax: 513-792-5844
Mailing address:
  • Phone: 513-751-2145
  • Fax: 513-751-2138

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number33289
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35.033591
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number01037532A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: