Provider Demographics
NPI:1114069481
Name:SZTENDERA, LORA DEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:LORA
Middle Name:DEAN
Last Name:SZTENDERA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LORA
Other - Middle Name:DEAN
Other - Last Name:SZTENDERA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:407 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CAMPBELLSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42718-1387
Mailing Address - Country:US
Mailing Address - Phone:270-465-4841
Mailing Address - Fax:270-465-0120
Practice Address - Street 1:407 E 1ST ST
Practice Address - Street 2:
Practice Address - City:CAMPBELLSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42718-1387
Practice Address - Country:US
Practice Address - Phone:270-465-4841
Practice Address - Fax:270-465-0120
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY26865207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYF13151Medicare UPIN
KY0681101Medicare PIN