Healthcare Provider Details

I. General information

NPI: 1457334948
Provider Name (Legal Business Name): CHARLES D KERR D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2005
Last Update Date: 05/12/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 S CLEVELAND AVE
WESTERVILLE OH
43081-1329
US

IV. Provider business mailing address

70 S CLEVELAND AVE
WESTERVILLE OH
43081-1329
US

V. Phone/Fax

Practice location:
  • Phone: 614-890-6555
  • Fax: 614-823-8881
Mailing address:
  • Phone: 614-890-6555
  • Fax: 614-823-8881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number34-00-2892-K
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code2086S0105X
TaxonomySurgery of the Hand (Surgery) Physician
License Number34.002892
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: