Individual
KENNETH D LORENZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
422 POPLAR ST, TERRE HAUTE, IN 47807-4209
(812) 242-3700
(812) 234-3565
Mailing address
221 S 6TH ST, TERRE HAUTE, IN 47807-4214
(812) 242-3700
(812) 234-3565
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18001615A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000089617
ANTHEM
—
01
—
0182864
US DEPT OF LABOR
—
01
—
02096
CIGNA
—
05
—
100150840
—
IN
01
—
100150840D
MOLINA HEALTHCARE MCAID
IN
01
—
243410
HEALTHLINK
—
01
—
351904269136
CARESOURCE MEDICAID
—
01
—
4351954
AETNA
—
01
—
791580270
RAILROAD MCARE PALAMETTO
—
01
—
I017569C004
UNISYS CHAMPUS SECONDARY
—
01
—
N280839
HARMONY HEALTH PLAN IND
—
01
—
P00834935
RAILROAD MEDICARE
IN
Enumeration date
08/29/2006
Last updated
08/18/2010
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