Healthcare Provider Details

I. General information

NPI: 1356358444
Provider Name (Legal Business Name): LORI ANN KUEHNE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 11/26/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 MONROE ST
DOVER OH
44622-2046
US

IV. Provider business mailing address

603 MONROE ST
DOVER OH
44622-2046
US

V. Phone/Fax

Practice location:
  • Phone: 330-364-8889
  • Fax: 330-343-7505
Mailing address:
  • Phone: 330-364-8889
  • Fax: 330-343-7505

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number18938
License Number StateND
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number72433
License Number StateMN
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number61811
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: