Provider Demographics
NPI:1396793022
Name:HUNEKE, ALLEN L (MD)
Entity type:Individual
Prefix:DR
First Name:ALLEN
Middle Name:L
Last Name:HUNEKE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 CHAMBER CENTER DR
Mailing Address - Street 2:ST. ELIZABETH PHYSICIANS
Mailing Address - City:LAKESIDE PARK
Mailing Address - State:KY
Mailing Address - Zip Code:41017-1673
Mailing Address - Country:US
Mailing Address - Phone:859-344-5555
Mailing Address - Fax:859-344-5552
Practice Address - Street 1:1 MEDICAL VILLAGE DR
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:KY
Practice Address - Zip Code:41017-3403
Practice Address - Country:US
Practice Address - Phone:859-301-2440
Practice Address - Fax:859-301-2493
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2013-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35038498H207V00000X
KY36001207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0395755Medicaid
IN200256210Medicaid
KY64013592Medicaid
A78808Medicare UPIN
OH0395755Medicaid
KY3316367Medicare PIN
KY64013592Medicaid
KY0969480Medicare PIN