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NPI Code Detail

MEDICARE: KENNETH L LOVKO PHD

MEDICARE:   KENNETH L LOVKO  PHD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist20040534AIN

General Provider Information

NPI Number : 1568462422
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH L LOVKO PHD
Provider Business Mailing Address
First Line : 697 PRO-MED LN
Second Line :
City : CARMEL
State : IN
Zip : 46032-5323
Country : US
Telephone Number : 317-587-0567
Fax Number : 317-574-1230
Provider Business Practice Location Address
First Line : 2506 WILLOWBROOK PKWY
Second Line : SUITE 300
City : INDIANAPOLIS
State : IN
Zip : 46205-1564
Country : US
Telephone Number : 317-587-0567
Fax Number : 317-574-1230
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/21/2005
Last Update Date : 07/08/2007

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Directions to “ KENNETH L LOVKO PHD” Practice Location

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