Doctor Name: | MS. PHYLLIS MARIE KAZIMER |
NPI Number: | 1164611018 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A.-C. |
License Number: | 50000764 |
Business Practice Address: | 182 East Ave Tallmadge, OH - 442782311 |
Business Phone Number: | 3306309726 |
Business Fax Number: | |
Mailing Address: | 182 East Ave, TALLMADGE |
State: | OH |
Postal Code: | 442782311 |
Phone Number: | 3306309726 |
Fax Number: | |
NPI Enumeration Date: | 10/17/2007 |
NPI Last Update Date: | 10/17/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 50000764 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OH |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |