Healthcare Provider Details

I. General information

NPI: 1386768638
Provider Name (Legal Business Name): REBECCA ANN KUENNEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 01/20/2021
Certification Date: 01/20/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6435 POST RD
DUBLIN OH
43016
US

IV. Provider business mailing address

700 ACKERMAN RD STE 2120
COLUMBUS OH
43202-1559
US

V. Phone/Fax

Practice location:
  • Phone: 614-293-8116
  • Fax: 614-685-1941
Mailing address:
  • Phone: 614-293-8116
  • Fax: 614-293-3555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number35089840
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number35089840
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: