Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 935-2 | KS |
NPI | 1013122472 |
---|---|
Provider Name | Dr. Jim L Kuhlmann |
First Address | Wichita, KS 67206-2362 |
Second Address | Wichita, KS 67206-2362 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T80112 | (02) | KS |