Stallings, Kenneth Craig
Stallings, Kenneth Craig is an sole proprietor health care provider with primary practice located at 5801 Blue Ridge Dr , Blue Ridge GA 30513-3245. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Stallings, Kenneth Craig can be contacted via phone (706) 632-0384.Contact Information
Primary practice address
5801 Blue Ridge Dr
Blue Ridge GA 30513-3245
Phone: (706) 632-0384
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 00013 | Georgia |
Profile Details
| NPI number | 1205900909 |
|---|---|
| LBN Legal business name | Stallings, Kenneth Craig |
| Credentials | L..O. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 17th, 2006 |
| Last updated | Feb 15th, 2013 - about 13 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 | 1205900909 | NPPES |
| Georgia | MEDICAID | 003128965A |
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