Provider Demographics
NPI:1437772431
Name:KALIL, NATHAN JEFFREY (DPM)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:JEFFREY
Last Name:KALIL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3255 E LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43227-1967
Mailing Address - Country:US
Mailing Address - Phone:614-239-9444
Mailing Address - Fax:614-237-5220
Practice Address - Street 1:3255 E LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43227-1967
Practice Address - Country:US
Practice Address - Phone:614-239-9444
Practice Address - Fax:614-237-5220
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-26
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD305016213ES0103X
OH36.004108213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0035893Medicaid