Provider Demographics
NPI:1538395066
Name:DEVOR, KRISTIN E (DO)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:E
Last Name:DEVOR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:ELIZABETH
Other - Last Name:BODKIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1975 GUILFORD RD
Mailing Address - Street 2:
Mailing Address - City:UPPER ARLINGTON
Mailing Address - State:OH
Mailing Address - Zip Code:43221-4300
Mailing Address - Country:US
Mailing Address - Phone:614-869-0139
Mailing Address - Fax:614-869-0140
Practice Address - Street 1:1975 GUILFORD RD
Practice Address - Street 2:
Practice Address - City:UPPER ARLINGTON
Practice Address - State:OH
Practice Address - Zip Code:43221-4300
Practice Address - Country:US
Practice Address - Phone:614-869-0139
Practice Address - Fax:614-869-0140
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-10
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34.020663207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0073062Medicaid
OHH161090Medicare PIN