Healthcare Provider Details

I. General information

NPI: 1053161703
Provider Name (Legal Business Name): THOMAS KELLY KUEHN DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2024
Last Update Date: 08/17/2026
Certification Date: 08/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

245 FOUNTAIN CT STE 215
LEXINGTON KY
40509-2792
US

IV. Provider business mailing address

417 K ST
SALT LAKE CITY UT
84103-3624
US

V. Phone/Fax

Practice location:
  • Phone: 859-323-6861
  • Fax: 859-323-1194
Mailing address:
  • Phone: 614-464-7255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberR7096
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: