Healthcare Provider Details

I. General information

NPI: 1457329310
Provider Name (Legal Business Name): KENNETH W BUEHLMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 09/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

528 N 1ST ST
VINCENNES IN
47591-1402
US

IV. Provider business mailing address

406 N 1ST ST
VINCENNES IN
47591-1340
US

V. Phone/Fax

Practice location:
  • Phone: 812-882-4434
  • Fax: 812-885-6318
Mailing address:
  • Phone: 812-882-4434
  • Fax: 812-885-6318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number01028242A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: