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General NPI Number Information
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NPI Number | 1114993862
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Entity Type | Individual
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Provider Name | ROGER W. KUNES PA
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Gender | Male
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 04/17/2023
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Provider Practice Location Address
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Address Line | 1320 MERCY DR NW
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City | CANTON
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State | OH
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Zip | 44708-2614
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Country | US
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Telephone | 330-489-1455
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Fax |
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Provider Business Mailing Address
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Address Line | 753 MARBURY CIR NE
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City | HARTVILLE
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State | OH
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Zip | 44632-8899
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Country | US
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Telephone | 330-949-7777
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 003226
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 50.002776
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License Number State | OH
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