MEDICARE: DOUGLAS H. KAHN, DPM, PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	PO 2703	FL

General Provider Information

NPI Number	:	1306876644
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOUGLAS H. KAHN, DPM, PA

Provider Business Mailing Address
First Line	:	12180 28TH ST N
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33716-1820
Country	:	US
Telephone Number	:	727-572-5449
Fax Number	:	727-573-2048

Provider Business Practice Location Address
First Line	:	1114 EAST DUVAL STREET
Second Line	:
City	:	LAKE CITY
State	:	FL
Zip	:	32055
Country	:	US
Telephone Number	:	386-752-7813
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DOUGLAS HOWARD KAHN
Credential	:	D.P.M.
Telephone Number	:	561-213-3757

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	08/22/2020

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