Healthcare Provider Details

I. General information

NPI: 1548451040
Provider Name (Legal Business Name): WILLIAM BRIAN KUHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 05/20/2021
Certification Date: 05/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3750 LANDMARK DR STE B
LAFAYETTE IN
47905-6652
US

IV. Provider business mailing address

311 N CLYDE MORRIS BLVD SUITE 550
DAYTONA BEACH FL
32114-2781
US

V. Phone/Fax

Practice location:
  • Phone: 317-396-1300
  • Fax: 765-447-4172
Mailing address:
  • Phone: 386-425-8582
  • Fax: 386-252-1776

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License NumberME0058223
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number01032786A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: