Individual
DR. BRUCE LEE KINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1400 E 2ND ST, DEFIANCE, OH 43512
(419) 784-1414
(419) 783-2799
Mailing address
2200 JEFFERSON AVE FL 5, TOLEDO, OH 43604-7102
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
2009017807
MO
207V00000X
Obstetrics & Gynecology Physician
Primary
35-050789
OH
207V00000X
Obstetrics & Gynecology Physician
39346
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000384921
ANTHEM BLUE CROSS PIN
KY
05
—
0658999
—
OH
05
—
64097256
—
KY
01
—
H327901
MEDICARE PTAN
OH
Enumeration date
03/28/2006
Last updated
08/27/2018
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