Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | KP000796 | MI |
N | 222Z00000X | Podiatrist | KP000796 | MI |
Y | 213E00000X | Podiatrist | PO990 | FL |
Y | 222Z00000X | Podiatrist | PO990 | FL |
NPI | 1033123948 |
---|---|
Provider Name | Kenneth D Poss |
First Address | Delray Beach, FL 33445 |
Second Address | Delray Beach, FL 33445 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T34419 | (02) |