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General NPI Number Information
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NPI Number | 1174515068
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Entity Type | Individual
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Provider Name | KRISTIN K TITKO DPM
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Gender | Female
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Dates
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Enumeration Date | 08/17/2005
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Last Update Date | 05/19/2016
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Provider Practice Location Address
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Address Line | 6770 CINCINNATI DAYTON RD SUITE 201
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City | LIBERTY TOWNSHIP
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State | OH
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Zip | 45044-9318
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Country | US
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Telephone | 513-729-4455
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Fax | 513-644-4993
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Provider Business Mailing Address
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Address Line | 6770 CINCINNATI DAYTON RD SUITE 201
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City | LIBERTY TOWNSHIP
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State | OH
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Zip | 45044-9318
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Country | US
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Telephone | 513-729-4455
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Fax | 513-644-4993
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 2794
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License Number State | OH
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