Provider Demographics
NPI:1366914939
Name:KARACSON, KINGA (PA-C)
Entity type:Individual
Prefix:
First Name:KINGA
Middle Name:
Last Name:KARACSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1667 HAMPTON KNOLL DR
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44313-4874
Mailing Address - Country:US
Mailing Address - Phone:440-554-4939
Mailing Address - Fax:
Practice Address - Street 1:4650 HILLS AND DALES RD NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44708-6220
Practice Address - Country:US
Practice Address - Phone:330-491-9675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-20
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50.005782RX363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
1137959OtherNCCPA
OH50.005782RXOtherOHIO STATE MEDICAL BOARD PA LICENSE