Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 0101045013 | VA |
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 25MA04253700 | NJ |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | D0039789 | MD |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD022241E | PA |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | MD18544 | DC |
NPI | 1073529244 |
---|---|
Provider Name | Dr. George R Kenner JR. |
First Address | Wayne, PA 19087-1802 |
Second Address | Vineland, NJ 08360-7056 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/07/2006 |
Last Update Date | 21/11/2013 |