Healthcare Provider Details

I. General information

NPI: 1467548024
Provider Name (Legal Business Name): KIPP VERLING KASTENS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 04/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6435 E BROAD ST
COLUMBUS OH
43213-1507
US

IV. Provider business mailing address

6440 MEADOWBROOK CIR
WORTHINGTON OH
43085
US

V. Phone/Fax

Practice location:
  • Phone: 614-355-8160
  • Fax: 614-355-8180
Mailing address:
  • Phone: 614-436-2317
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35 036184
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number35 036184
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: