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General NPI Number Information
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NPI Number | 1558351783
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Entity Type | Organization
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Legal Business Name | KALIDA MEDICAL ARTS, INC.
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Dates
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Enumeration Date | 10/27/2005
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Last Update Date | 07/19/2023
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Provider Practice Location Address
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Address Line | 109 S BROAD ST
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City | KALIDA
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State | OH
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Zip | 45853
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Country | US
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Telephone | 419-532-3958
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Fax | 419-532-2326
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Provider Business Mailing Address
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Address Line | PO BOX 417 109 SOUTH BROAD ST
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City | KALIDA
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State | OH
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Zip | 45853-0417
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Country | US
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Telephone | 419-532-3958
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Fax | 419-532-2326
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Authorized Official
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Title or Position | PRESIDENT
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Name | WESLEY KLIR
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Credential | MD
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Telephone | 419-532-3958
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 35075209
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 049354
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License Number State | OH
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