Provider Demographics
NPI:1679309116
Name:KLUESNER, SAMUEL (PHARMD, BCPS)
Entity type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:KLUESNER
Suffix:
Gender:M
Credentials:PHARMD, BCPS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4123 CALDER DR
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47909-6256
Mailing Address - Country:US
Mailing Address - Phone:765-516-2930
Mailing Address - Fax:
Practice Address - Street 1:3500 S LAFOUNTAIN ST
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-3803
Practice Address - Country:US
Practice Address - Phone:765-776-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-11
Last Update Date:2024-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26029243A1835C0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835C0206XPharmacy Service ProvidersPharmacistCardiology