Kenneth W Kellough in Clarksdale - Internal Medicine
Kenneth W Kellough - NPI 1609815000
Kenneth W Kellough is a Internal Medicine in Clarksdale, Mississippi. Kenneth W Kellough practices all healthcare services and medical treatments related to Internal Medicine. The NPI Number for Kenneth W Kellough is 1609815000. The last update date is 2009-12-03.
Kenneth W Kellough's current location address is 705 N State St, Clarksdale, Mississippi. You can contact this provider via phone number 6626212192 and fax number 6626212314. The mailing address for Kenneth W Kellough is 705 N State St, Clarksdale, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth W Kellough |
|---|---|
| Address | 705 N State St, Clarksdale, Mississippi |
| Phone Number | 6626212192 |
| Fax Number | 6626212314 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1609815000 |
|---|---|
| Provider Enumeration Date | 2006-06-04 |
| Last Updated Date | 2009-12-03 |
Provider Mailing Address Detail
| Address | 705 N State St |
|---|---|
| City | Clarksdale |
| State | Mississippi (MS) |
| Post Code | 386146519 |
| Phone Number | 6626212192 |
| Fax Number | 6626212314 |
Provider's Primary Taxonomy Detail
| Speciality | Internal Medicine |
|---|---|
| Taxonomy | 207R00000X |
| Licence No | 16776 |
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Definition: A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and di |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 121009 | MS | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Kenneth W Kellough by the Centers for Medicare & Medicaid Services (CMS)?
The Kenneth W Kellough has been assigned the NPI (National Provider Identifier) 1609815000. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please share the complete physical location address where Kenneth W Kellough's facilities are situated?
The facilities of Kenneth W Kellough are physically located at the following address: 705 N State St, Clarksdale, MS, 386146519.
What is Kenneth W Kellough's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Kenneth W Kellough is Internal Medicine, and the corresponding taxonomy classification code for this specialized field is 207R00000X.
When did Kenneth W Kellough receive its 1609815000 assignment?
The Kenneth W Kellough was assigned its 1609815000 on 2006-06-04, which is the date when this unique identifier was issued to the organization.
As of what date were the Kenneth W Kellough's details last updated?
The information pertaining to the Kenneth W Kellough, including its address, specialty, and other details, was most recently updated on 2009-12-03.