Wayne, Kenneth S

Wayne, Kenneth S is an individual health care provider with primary practice located at 1005 Pennsylvania Ave Suite 104, Ottumwa IA 52501-6413. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Pulmonary Disease. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Wayne, Kenneth S can be contacted via phone (641) 682-4594.

Contact Information

Primary practice address
1005 Pennsylvania Ave Suite 104 Ottumwa IA 52501-6413
Phone: (641) 682-4594
Fax: (641) 682-2123
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 32349 Iowa
Allopathic & Osteopathic Physicians / Pulmonary Disease 207RP1001X 32349 Iowa

Profile Details

NPI number 1174500151
LBN Legal business name Wayne, Kenneth S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2005
Last updated May 17th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174500151 NPPES
Iowa MEDICAID 2169417
Iowa MEDICAID 1174500151
Iowa MEDICAID 0169417
Iowa Other 110166527
Iowa MEDICAID 1169417

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