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General NPI Number Information
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NPI Number | 1154536878
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Entity Type | Organization
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Legal Business Name | THOMAS W. KUNKEL, DPM, INC.
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 12/12/2007
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Provider Practice Location Address
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Address Line | 1099 E LIBERTY ST
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City | GIRARD
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State | OH
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Zip | 44420-2407
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Country | US
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Telephone | 330-759-4724
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Fax | 330-759-5168
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Provider Business Mailing Address
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Address Line | 1099 E LIBERTY ST
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City | GIRARD
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State | OH
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Zip | 44420-2407
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Country | US
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Telephone | 330-759-4724
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Fax | 330-759-5168
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Authorized Official
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Title or Position | PODIATRIST
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Name | DR. THOMAS W KUNKEL
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Credential |
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Telephone | 330-759-4724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 36002367K
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License Number State | OH
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