Healthcare Provider Details

I. General information

NPI: 1831194992
Provider Name (Legal Business Name): KENNETH SON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2005
Last Update Date: 08/13/2025
Certification Date: 08/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 MCKINLEY PARK DR
MARION OH
43302-6399
US

IV. Provider business mailing address

PO BOX 7527
DUBLIN OH
43017-0727
US

V. Phone/Fax

Practice location:
  • Phone: 740-383-8473
  • Fax: 740-383-8695
Mailing address:
  • Phone: 614-544-6366
  • Fax: 614-544-6350

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number4301100071
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4901004799
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number4301100071
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: