Basic Information
| Provider Information | |||||||||
| NPI: | 1548451040 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KUHN | ||||||||
| FirstName: | WILLIAM | ||||||||
| MiddleName: | BRIAN | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 311 N CLYDE MORRIS BLVD | ||||||||
| Address2: | SUITE 550 | ||||||||
| City: | DAYTONA BEACH | ||||||||
| State: | FL | ||||||||
| PostalCode: | 321142781 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3864258582 | ||||||||
| FaxNumber: | 3862521776 | ||||||||
| Practice Location | |||||||||
| Address1: | 3750 LANDMARK DR STE B | ||||||||
| Address2: | |||||||||
| City: | LAFAYETTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 479056652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173961300 | ||||||||
| FaxNumber: | 7654474172 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/08/2007 | ||||||||
| LastUpdateDate: | 05/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | ME0058223 | FL | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 01032786A | IN | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 064700400 | 05 | FL | MEDICAID | 11486 | 01 | BLUE CROSS | OTHER |