MEDICARE: DR. KENNETH L MAPES MD

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	207P00000X	Emergency Medicine Physician	35074338	OH
2	207P00000X	Emergency Medicine Physician	ME117705	FL
3	207P00000X	Emergency Medicine Physician	01068774A	IN
4	208D00000X	General Practice Physician	26955	WV
5	208D00000X	General Practice Physician	35074338	OH
6	207P00000X	Emergency Medicine Physician	26955	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000246975	OTHER	OH	ANTHEM
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841292760
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH L MAPES MD

Provider Business Mailing Address
First Line	:	3221 N BOLANDER RD
Second Line	:
City	:	GENOA
State	:	OH
Zip	:	43430-9739
Country	:	US
Telephone Number	:	419-855-0234
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 1ST AVE
Second Line	:
City	:	HUNTINGTON
State	:	WV
Zip	:	25702-1241
Country	:	US
Telephone Number	:	419-260-2356
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2005
Last Update Date	:	11/27/2023

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Directions to “ DR. KENNETH L MAPES MD” Practice Location

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