Hardigan, Kenneth Russell
Hardigan, Kenneth Russell is an individual health care provider with primary practice located at 100 Lantana Rd Ste 202A , Crossville TN 38555-1915. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Hardigan, Kenneth Russell can be contacted via phone (931) 484-5141.Contact Information
Primary practice address
100 Lantana Rd Ste 202A
Crossville TN 38555-1915
Phone: (931) 484-5141
Fax: (865) 374-2074
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 039120 | Georgia |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 65348 | Tennessee |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 65348 | Tennessee |
Profile Details
| NPI number | 1437148582 |
|---|---|
| LBN Legal business name | Hardigan, Kenneth Russell |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 20th, 2005 |
| Last updated | Nov 4th, 2024 - about 2 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 | 1437148582 | NPPES |
| Georgia | MEDICAID | 000852596A | |
| Georgia | MEDICAID | Q074573 | |
| Georgia | MEDICAID | 00627327G |
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