Provider Demographics
NPI:1568611622
Name:KUHN, EVAN R (OD)
Entity Type:Individual
Prefix:
First Name:EVAN
Middle Name:R
Last Name:KUHN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7295 GLORY RD
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56425-7308
Mailing Address - Country:US
Mailing Address - Phone:218-829-3848
Mailing Address - Fax:
Practice Address - Street 1:7295 GLORY RD
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-7308
Practice Address - Country:US
Practice Address - Phone:218-829-3848
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010093152W00000X
MN3127152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist