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General NPI Number Information
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NPI Number | 1548397375
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Entity Type | Individual
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Provider Name | KIMBERLY ANN SCRIVEN M.D.
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Gender | Female
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2231 TIMBER TRL
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City | BELLEFONTAINE
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State | OH
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Zip | 43311-9036
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Country | US
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Telephone | 937-292-3474
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Fax |
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Provider Business Mailing Address
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Address Line | 10273 MANTLE RD
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City | ORIENT
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State | OH
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Zip | 43146-9039
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Country | US
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Telephone | 216-470-6272
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Fax | 937-592-5285
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 78371
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 12949
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License Number State | NH
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 48610020
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License Number State | WI
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