Basic Information
| Provider Information | |||||||||
| NPI: | 1912954884 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NORTON | ||||||||
| FirstName: | KAVITHA | ||||||||
| MiddleName: | P | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 453 W 10TH AVE | ||||||||
| Address2: | 246 ATWELL HALL | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432102205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142932957 | ||||||||
| FaxNumber: | 6146883700 | ||||||||
| Practice Location | |||||||||
| Address1: | 453 W 10TH AVE | ||||||||
| Address2: | 246 ATWELL HALL | ||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 432102205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142932957 | ||||||||
| FaxNumber: | 6146883700 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/27/2006 | ||||||||
| LastUpdateDate: | 03/10/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 34008577 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RH0002X | 34008577 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2607441 | 05 | OH | MEDICAID |