Provider Demographics
NPI:1427045772
Name:KUHLENGEL, KEITH R (MD)
Entity Type:Individual
Prefix:
First Name:KEITH
Middle Name:R
Last Name:KUHLENGEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1671 CROOKED OAK DR
Mailing Address - Street 2:LANCASTER NEUROSCIENCE & SPINE ASSOCIATES
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4207
Mailing Address - Country:US
Mailing Address - Phone:717-569-5331
Mailing Address - Fax:717-569-4210
Practice Address - Street 1:1671 CROOKED OAK DR
Practice Address - Street 2:LANCASTER NEUROSCIENCE & SPINE ASSOCIATES
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4207
Practice Address - Country:US
Practice Address - Phone:717-569-5331
Practice Address - Fax:717-569-4210
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2012-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD041565L207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0012163290002Medicaid
PA0012163290002Medicaid
621048FX1Medicare ID - Type Unspecified