MEDICARE: DR. WILLIAM BOWMAN KUYKENDALL PH.D.

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
1	103T00000X	Psychologist	3004	OH

General Provider Information

NPI Number	:	1639395627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM BOWMAN KUYKENDALL PH.D.

Provider Business Mailing Address
First Line	:	1580 GUILFORD RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-3851
Country	:	US
Telephone Number	:	614-486-9298
Fax Number	:

Provider Business Practice Location Address
First Line	:	1580 GUILFORD RD
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43221-3851
Country	:	US
Telephone Number	:	614-486-9298
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/18/2007
Last Update Date	:	07/08/2007

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