Individual
HARRY T KITTAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
12340 STATE ROUTE 104, WAVERLY, OH 45690-8968
(740) 941-5180
Mailing address
12340 STATE ROUTE 104, WAVERLY, OH 45690-8968
(740) 941-5180
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.076602
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2133828
—
OH
Enumeration date
07/17/2006
Last updated
03/11/2021
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