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NPI Code Detail

MEDICARE: LIZBETH J KUHN HEMMELGARN OD

MEDICARE: LIZBETH J KUHN HEMMELGARN OD
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
1152W00000XOptometrist5397/T2308OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
15397/T2308OTHEROHLICENSE

General Provider Information

NPI Number : 1710966585
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIZBETH J KUHN HEMMELGARN OD
Provider Business Mailing Address
First Line : 102 E LAKE AVE
Second Line :
City : NEW CARLISLE
State : OH
Zip : 45344-1417
Country : US
Telephone Number : 937-845-0751
Fax Number : 937-845-2931
Provider Business Practice Location Address
First Line : 102 E LAKE AVE
Second Line :
City : NEW CARLISLE
State : OH
Zip : 45344-1417
Country : US
Telephone Number : 937-845-0751
Fax Number : 937-845-2931
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/11/2006
Last Update Date : 06/27/2008

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