Healthcare Provider Details

I. General information

NPI: 1013925908
Provider Name (Legal Business Name): ROBERT LEE KUYKENDAL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 DELTA AVE
CINCINNATI OH
45226-1221
US

IV. Provider business mailing address

820 DELTA AVE
CINCINNATI OH
45226-1221
US

V. Phone/Fax

Practice location:
  • Phone: 513-321-9902
  • Fax: 513-533-8851
Mailing address:
  • Phone: 513-321-9902
  • Fax: 513-533-8851

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number037032
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: