| Kenneth Kennedy, | |
|
1655 N Gladstone Ave Ste E, Columbus, IN 47201-5380 | |
| (812) 657-8080 | |
| (502) 561-7280 |
| Full Name | Kenneth Kennedy |
|---|---|
| Gender | Male |
| Speciality | Otolaryngology |
| Location | 1655 N Gladstone Ave Ste E, Columbus, Indiana |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841653581 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Y00000X | Otolaryngology | 96157 (Georgia) | Secondary |
| 207Y00000X | Otolaryngology | 01085486A (Indiana) | Primary |
| Entity Name | Southern Indiana Ent Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013030618 PECOS PAC ID: 6507964137 Enrollment ID: O20070606000064 |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth Kennedy, 1655 N Gladstone Ave Ste E, Columbus, IN 47201-5380 Ph: (812) 657-8080 | Kenneth Kennedy, 1655 N Gladstone Ave Ste E, Columbus, IN 47201-5380 Ph: (812) 657-8080 |
Dr. Christopher E Stevens, M.D. Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 2345 Northpark Dr, Columbus, IN 47203 Phone: 812-669-1490 Fax: 812-669-1491 | |
Anthony D Sanders, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1655 N Gladstone Ave, Ste E, Columbus, IN 47201 Phone: 812-376-3071 Fax: 812-378-5721 | |
Frederick Porter, MD Otolaryngology Medicare: Not Enrolled in Medicare Practice Location: 1655 N Gladstone Ave, Ste E, Columbus, IN 47201 Phone: 812-376-3071 Fax: 812-378-5721 | |
Nicholas C Hollenkamp, MD Otolaryngology Medicare: Accepting Medicare Assignments Practice Location: 1655 N Gladstone Ave, Columbus, IN 47201 Phone: 812-376-3071 Fax: 812-378-5721 |