Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0117X | Orthopaedic Spine Surgeon | 036126727 | IL |
Y | 207XS0117X | Orthopaedic Spine Surgeon | 42721 | KY |
NPI | 1386865426 |
---|---|
Provider Name | Dr. Kenneth Brandon Strenge |
First Address | Herrin, IL 62948 |
Second Address | Paducah, KY 42002 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 18/09/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7100091940 | (05) | KY |