Provider Demographics
NPI:1619910585
Name:LORENZ, ROBERT N (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:N
Last Name:LORENZ
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 1:4900 HOUSTON RD
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-4824
Mailing Address - Country:US
Mailing Address - Phone:859-212-7700
Mailing Address - Fax:859-212-7710
Practice Address - Street 1:4900 HOUSTON RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4824
Practice Address - Country:US
Practice Address - Phone:859-212-7700
Practice Address - Fax:859-212-7710
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY21351207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY110133712OtherRAILROAD MEDICARE
KY64213515Medicaid
KYP00823723OtherRAILROAD MEDICARE
OH0412682Medicaid
KYC73382Medicare UPIN
KY64213515Medicaid
KY008580079Medicare PIN