Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | ME 73354 | FL |
NPI | 1073519310 |
---|---|
Provider Name | Dr. Kenneth A Essig |
First Address | Clearwater, FL 33757-8744 |
Second Address | Winter Haven, FL 33884-3263 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/06/2005 |
Last Update Date | 02/09/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
014245200 | (05) | FL |
F06369 | (02) | FL |