Healthcare Provider Details

I. General information

NPI: 1811969009
Provider Name (Legal Business Name): CLIFFORD C KUHN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 E CHESTNUT ST
LOUISVILLE KY
40202-1831
US

IV. Provider business mailing address

PO BOX 69 ATTENTION JILL VAUGHN
LOUISVILLE KY
40201-0069
US

V. Phone/Fax

Practice location:
  • Phone: 502-852-5392
  • Fax: 502-852-1115
Mailing address:
  • Phone: 502-852-5392
  • Fax: 502-852-1115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number17689
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: