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General NPI Number Information
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NPI Number | 1942868484
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Entity Type | Individual
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Provider Name | KATHYRN JANELL RICKARD DO
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Gender | Female
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Dates
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Enumeration Date | 05/30/2019
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Last Update Date | 07/12/2022
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Provider Practice Location Address
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Address Line | 8054 DARROW RD STE 3
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City | TWINSBURG
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State | OH
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Zip | 44087-2387
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Country | US
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Telephone | 330-425-1485
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Fax | 330-405-7960
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Provider Business Mailing Address
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Address Line | 8054 DARROW RD STE 3
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City | TWINSBURG
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State | OH
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Zip | 44087-2387
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Country | US
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Telephone | 330-425-1485
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Fax | 330-405-7960
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OT019109
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License Number State | PA
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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 | 34.015957
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License Number State | OH
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