Provider Demographics
NPI:1720073240
Name:KAY, KIRSTEN RUTH (MD)
Entity type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:RUTH
Last Name:KAY
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 1:721 MIAMI CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45417-4650
Mailing Address - Country:US
Mailing Address - Phone:937-281-6800
Mailing Address - Fax:937-281-6800
Practice Address - Street 1:721 MIAMI CHAPEL RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45417-4650
Practice Address - Country:US
Practice Address - Phone:937-281-6800
Practice Address - Fax:937-965-4595
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35081473208000000X, 2080P0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2337797Medicaid