Healthcare Provider Details

I. General information

NPI: 1275478125
Provider Name (Legal Business Name): KEVIN ELLIOTT ALBRIGHT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/20/2026
Last Update Date: 04/20/2026
Certification Date: 04/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13166 RITA ST
PAULDING OH
45879-8896
US

IV. Provider business mailing address

13166 RITA STREET
PAULDING OH
45879
US

V. Phone/Fax

Practice location:
  • Phone: 419-399-2444
  • Fax: 419-399-2444
Mailing address:
  • Phone: 419-399-2444
  • Fax: 419-399-2444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: