Healthcare Provider Details

I. General information

NPI: 1396855664
Provider Name (Legal Business Name): DARRIN J KUCZYNSKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 08/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 HOSPITAL DR
DOVER OH
44622-2058
US

IV. Provider business mailing address

205 HOSPITAL DR
DOVER OH
44622-2058
US

V. Phone/Fax

Practice location:
  • Phone: 330-343-3335
  • Fax: 330-364-5720
Mailing address:
  • Phone: 330-343-3335
  • Fax: 330-364-5720

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number35-065725
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: