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Kimacovich, Richard Glenn

CPSO#: 66176

MEMBER STATUS

Active Member as of 19 Jan 1993

CURRENT OR PAST CPSO REGISTRATION CLASS

Independent Practice as of 19 Jan 1993

Summary

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Former Name: No Former Name

Gender: Male

Languages Spoken: English

Education: University of Manitoba, 1988

Practice Information

Primary Location of Practice

St. Catharines General Hospital
1200 4th Avenue
St Catharines ON L2S 0A9
Phone: (905) 684-7271
Fax: 2893981067 Electoral District: 04

Additional Practice Location(s)

Out 'n' About
264 Welland Avenue
St Catharines ON L2R 2P8
Canada
Phone: 289-479-5090
Fax: 905-984-8574
County: Regional Municipality of Niagara
Electoral District: 04

Professional Corporation Information

Corporation Name: Kimacovich Medicine Professional Corporation
Certificate of Authorization Status: Issued Date: Aug 02 2006

Shareholders:
Dr. R. Kimacovich ( CPSO# 66176 )

Business Address:
264 Welland Avenue
St Catharines ON L2R 2P8
Phone Number: (289) 479-5090

Business Address:
1200 Fourth Avenue
St Catharines ON L2S 0A9
Phone Number: (905) 684-7271

Hospital Privileges

Hospital	Location
Niagara Health System,St Catharines General Site	St Catharines

Specialties

Specialty	Issued On	Type
Family Medicine	Effective:03 Jun 1998	CFPC Specialist
Family Medicine (Emergency Medicine)	Effective:01 Dec 1999	CFPC Specialist

Terms and Conditions

(1) Dr. RICHARD GLENN KIMACOVICH may practise only in the areas of medicine in which Dr. KIMACOVICH is educated and experienced.

Registration History

Action	Issue Date
First certificate of registration issued: Independent Practice Certificate	Effective: 19 Jan 1993