Provider Demographics
NPI:1144471798
Name:KAST, DOUGLAS R (DO)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:R
Last Name:KAST
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:231 SEASONS RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:HUDSON
Mailing Address - State:OH
Mailing Address - Zip Code:44224
Mailing Address - Country:US
Mailing Address - Phone:330-662-5666
Mailing Address - Fax:330-655-3845
Practice Address - Street 1:231 SEASONS RD
Practice Address - Street 2:SUITE 300
Practice Address - City:HUDSON
Practice Address - State:OH
Practice Address - Zip Code:44224
Practice Address - Country:US
Practice Address - Phone:330-662-5666
Practice Address - Fax:330-655-3845
Is Sole Proprietor?:No
Enumeration Date:2008-10-01
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH34010770207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine