Healthcare Provider Details

I. General information

NPI: 1700804457
Provider Name (Legal Business Name): JOSEPH M. KUHN D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2006
Last Update Date: 12/14/2020
Certification Date: 12/14/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 SOUTH MAIN STREET BOX 529
PAYNE OH
45880
US

IV. Provider business mailing address

301 SOUTH MAIN STREET P.O. BOX 529
PAYNE OH
45880
US

V. Phone/Fax

Practice location:
  • Phone: 419-263-2947
  • Fax: 419-263-2515
Mailing address:
  • Phone: 419-263-2947
  • Fax: 419-263-2515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02001038A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34-004322
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: