Basic Information
| Provider Information | |||||||||
| NPI: | 1558344374 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KUMLER | ||||||||
| FirstName: | KARL | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | III | ||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 901 KENTON STATION DR | ||||||||
| Address2: | |||||||||
| City: | MAYSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410569609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6067595337 | ||||||||
| FaxNumber: | 6067595340 | ||||||||
| Practice Location | |||||||||
| Address1: | 901 KENTON STATION DR | ||||||||
| Address2: | |||||||||
| City: | MAYSVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 410569609 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6067595337 | ||||||||
| FaxNumber: | 6067595340 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/25/2005 | ||||||||
| LastUpdateDate: | 04/03/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 0980417 | OH | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0901393 | 01 | OH | DMERC | OTHER | 2179002 | 05 | OH | MEDICAID |