Healthcare Provider Details

I. General information

NPI: 1134708621
Provider Name (Legal Business Name): KEVIN JOHN KHOO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2021
Last Update Date: 07/19/2026
Certification Date: 07/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

IV. Provider business mailing address

9500 EUCLID AVE
CLEVELAND OH
44195-0001
US

V. Phone/Fax

Practice location:
  • Phone: 216-445-6915
  • Fax: 216-445-3694
Mailing address:
  • Phone: 216-445-6915
  • Fax: 216-445-3694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35.155585
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: