| Doctor Name: | DR. JOHN JAMES KAVLICH |
| NPI Number: | 1063413300 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 35057128K |
| Business Practice Address: | 276 W Bagley Rd Berea, OH - 440171878 |
| Business Phone Number: | 4408161888 |
| Business Fax Number: | 4408160786 |
| Mailing Address: | 276 W Bagley Rd, BEREA |
| State: | OH |
| Postal Code: | 440171878 |
| Phone Number: | 4408161888 |
| Fax Number: | 4408160786 |
| NPI Enumeration Date: | 08/09/2005 |
| NPI Last Update Date: | 08/11/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 35057128K |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OH |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |