Genova, Kenneth
Genova, Kenneth is an sole proprietor health care provider with primary practice located at 300 Medical Dr Suite 705, Lagrange GA 30240-4155. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Genova, Kenneth can be contacted via phone (706) 885-0111.Contact Information
Primary practice address
300 Medical Dr Suite 705
Lagrange GA 30240-4155
Phone: (706) 885-0111
Fax: (706) 885-0607
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 036977 | Georgia |
Profile Details
| NPI number | 1548239148 |
|---|---|
| LBN Legal business name | Genova, Kenneth |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 16th, 2006 |
| Last updated | May 16th, 2008 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548239148 | NPPES |
| Georgia | MEDICAID | 00542055A |
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