Provider Demographics
NPI:1669606018
Name:KERNER PMR LLC
Entity type:Organization
Organization Name:KERNER PMR LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:KERNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:614-792-3767
Mailing Address - Street 1:6905 HOSPITAL DR
Mailing Address - Street 2:SUITE 120
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9600
Mailing Address - Country:US
Mailing Address - Phone:614-792-3767
Mailing Address - Fax:614-792-3768
Practice Address - Street 1:6905 HOSPITAL DR
Practice Address - Street 2:SUITE 120
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9600
Practice Address - Country:US
Practice Address - Phone:614-792-3767
Practice Address - Fax:614-792-3768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-13
Last Update Date:2009-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35091057208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty