Healthcare Provider Details

I. General information

NPI: 1144220690
Provider Name (Legal Business Name): THOMAS A KIEFER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2005
Last Update Date: 07/15/2024
Certification Date: 07/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 BRADENTON AVE
DUBLIN OH
43017-7515
US

IV. Provider business mailing address

4835 LYTFIELD DR
DUBLIN OH
43017-2175
US

V. Phone/Fax

Practice location:
  • Phone: 614-233-9200
  • Fax: 614-233-9201
Mailing address:
  • Phone: 614-233-9200
  • Fax: 614-233-9201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number35046870
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: