Provider Demographics
NPI:1174731814
Name:K CHOKSI MD INC
Entity type:Organization
Organization Name:K CHOKSI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:K
Authorized Official - Middle Name:
Authorized Official - Last Name:CHOKSI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:330-929-2575
Mailing Address - Street 1:939 PORTAGE TRL
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3045
Mailing Address - Country:US
Mailing Address - Phone:330-929-2575
Mailing Address - Fax:330-929-2866
Practice Address - Street 1:939 PORTAGE TRL
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3045
Practice Address - Country:US
Practice Address - Phone:330-929-2575
Practice Address - Fax:330-929-2866
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH817932084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty
Not Answered2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2362812Medicaid
OHKR9346901Medicare ID - Type Unspecified
OH2362812Medicaid