Provider Demographics
NPI:1598916389
Name:KUHN, MARK R (BOC PO)
Entity Type:Individual
Prefix:
First Name:MARK
Middle Name:R
Last Name:KUHN
Suffix:
Gender:M
Credentials:BOC PO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 S BILLY JEAN DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65202-6518
Mailing Address - Country:US
Mailing Address - Phone:573-355-7546
Mailing Address - Fax:
Practice Address - Street 1:2900 S BILLY JEAN DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65202-6518
Practice Address - Country:US
Practice Address - Phone:573-355-7546
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-10
Last Update Date:2012-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC46875224P00000X, 222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist