Individual
LAWRENCE TENKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1935 BLUEGRASS AVE, SUITE 200, LOUISVILLE, KY 40215-1179
(502) 895-0040
(502) 361-4488
Mailing address
1935 BLUEGRASS AVE, SUITE 200, LOUISVILLE, KY 40215-1179
(502) 895-0040
(502) 361-4488
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
45644
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0075981
—
OH
05
—
201025590
—
IN
01
—
331420001
MEDICARE
IN
05
—
7100224410
—
KY
01
—
P01097674
MEDICARE RR
—
Enumeration date
10/17/2007
Last updated
07/14/2020
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