Healthcare Provider Details

I. General information

NPI: 1952551863
Provider Name (Legal Business Name): KUHN MEDICAL CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2008
Last Update Date: 09/07/2023
Certification Date: 08/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2240 KARISA DR STE 3
GOSHEN IN
46526-6943
US

IV. Provider business mailing address

2240 KARISA DR STE 3
GOSHEN IN
46526-6943
US

V. Phone/Fax

Practice location:
  • Phone: 574-537-8880
  • Fax: 574-537-8881
Mailing address:
  • Phone: 574-537-8880
  • Fax: 574-537-8881

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01040732A
License Number StateIN

VIII. Authorized Official

Name: ANDREW L KUHN
Title or Position: OWNER
Credential: M.D.
Phone: 574-537-8880