Healthcare Provider Details

I. General information

NPI: 1811901408
Provider Name (Legal Business Name): KENNETH M KUHN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 06/26/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 ROBBINS AVE STE C
NILES OH
44446-1769
US

IV. Provider business mailing address

234 ROBBINS AVE STE C
NILES OH
44446-1769
US

V. Phone/Fax

Practice location:
  • Phone: 330-574-5030
  • Fax: 330-574-5036
Mailing address:
  • Phone: 330-574-5030
  • Fax: 330-574-5036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number4118/T307
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: