Provider Demographics
NPI:1144275793
Name:SCHOFIELD, KIRA (MD)
Entity type:Individual
Prefix:
First Name:KIRA
Middle Name:
Last Name:SCHOFIELD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MEDICAL CENTER DR
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:FRANKLIN
Mailing Address - State:OH
Mailing Address - Zip Code:45005-5200
Mailing Address - Country:US
Mailing Address - Phone:937-425-7110
Mailing Address - Fax:937-425-7112
Practice Address - Street 1:200 MEDICAL CENTER DR
Practice Address - Street 2:4TH FLOOR
Practice Address - City:FRANKLIN
Practice Address - State:OH
Practice Address - Zip Code:45005-5200
Practice Address - Country:US
Practice Address - Phone:937-425-7110
Practice Address - Fax:937-425-7112
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-067598208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0989613Medicaid
OH0989613Medicaid
OH0771156Medicare PIN