Provider Demographics
NPI:1710966585
Name:KUHN HEMMELGARN, LIZBETH J (OD)
Entity Type:Individual
Prefix:
First Name:LIZBETH
Middle Name:J
Last Name:KUHN HEMMELGARN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 E LAKE AVE
Mailing Address - Street 2:
Mailing Address - City:NEW CARLISLE
Mailing Address - State:OH
Mailing Address - Zip Code:45344-1417
Mailing Address - Country:US
Mailing Address - Phone:937-845-0751
Mailing Address - Fax:937-845-2931
Practice Address - Street 1:102 E LAKE AVE
Practice Address - Street 2:
Practice Address - City:NEW CARLISLE
Practice Address - State:OH
Practice Address - Zip Code:45344-1417
Practice Address - Country:US
Practice Address - Phone:937-845-0751
Practice Address - Fax:937-845-2931
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2008-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH5397/T2308152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH5397/T2308OtherLICENSE
OH9347672Medicare PIN
OHV01887Medicare UPIN
OH4143622Medicare PIN
OH0228870001Medicare NSC
OH5397/T2308OtherLICENSE
OH4143621Medicare PIN