Healthcare Provider Details

I. General information

NPI: 1063639193
Provider Name (Legal Business Name): KIRA ANN ZIMMERLY M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 09/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9070 WINTON RD
CINCINNATI OH
45231-3828
US

IV. Provider business mailing address

4600 WESLEY AVE STE. N
CINCINNATI OH
45212-2298
US

V. Phone/Fax

Practice location:
  • Phone: 513-522-7600
  • Fax:
Mailing address:
  • Phone: 513-246-7000
  • Fax: 513-841-1580

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number089557
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: