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
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1205900909 NPPES
Georgia MEDICAID 003128965A

Popular Providers