Bannon, Kellen Thomas

Bannon, Kellen Thomas is an sole proprietor health care provider with primary practice located at 2213 Cherry St , Toledo OH 43608-2603. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Bannon, Kellen Thomas can be contacted via phone (419) 251-4724.

Contact Information

Primary practice address
2213 Cherry St Toledo OH 43608-2603
Phone: (419) 251-4724
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 2855 Tennessee

Profile Details

NPI number 1649535279
LBN Legal business name Bannon, Kellen Thomas
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 10th, 2012
Last updated Oct 25th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1649535279 NPPES
Tennessee MEDICAID 1649535279

Popular Providers