Kenneth Gene Sebrero Lacandazo, PT is a
Physical Medicine & Rehabilitation physician based in Monteagle, Tennessee. Kenneth Gene Sebrero Lacandazo is licensed to practice in Tennessee (license number 11420) and his current practice location is 26 2nd St, Monteagle, Tennessee. He can be reached at his office (for appointments etc.) via phone at
(932) 924-2041.
NPI number for Kenneth Gene Sebrero Lacandazo is 1093335812 and his current mailing address is 26 2nd St, Monteagle, Tennessee. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1093335812.
Physician's Profile
| Full Name | Kenneth Gene Sebrero Lacandazo |
|---|
| Gender | Male |
|---|
| Speciality | Physical Medicine & Rehabilitation |
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| Location | 26 2nd St, Monteagle, Tennessee |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1093335812
- Provider Enumeration Date: 04/22/2020
- Last Update Date: 04/22/2020
Medical Identifiers
Medical identifiers for Kenneth Gene Sebrero Lacandazo such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1093335812 | NPI | - | NPPES |
| 137911973 | Other | TN | DRIVER'S LICENSE |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 208100000X | Physical Medicine & Rehabilitation | 11420 (Tennessee) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Kenneth Gene Sebrero Lacandazo is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Kenneth Gene Sebrero Lacandazo, PT
26 2nd St,
Monteagle, TN 37356-7415
Ph: () - | Kenneth Gene Sebrero Lacandazo, PT
26 2nd St,
Monteagle, TN 37356-7415
Ph: (932) 924-2041 |
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