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NPI Code Detail

MEDICARE: KENNETH LESSENBERRY MD

MEDICARE: KENNETH LESSENBERRY MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician75424TN
2207Q00000XFamily Medicine Physician75424TN

General Provider Information

NPI Number : 1942060678
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH LESSENBERRY MD
Provider Business Mailing Address
First Line : 294 SUMMAR DR
Second Line :
City : JACKSON
State : TN
Zip : 38301-3915
Country : US
Telephone Number : 731-423-1932
Fax Number : 731-660-8739
Provider Business Practice Location Address
First Line : 294 SUMMAR DR
Second Line :
City : JACKSON
State : TN
Zip : 38301-3915
Country : US
Telephone Number : 731-423-1932
Fax Number : 731-660-8739
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2024
Last Update Date : 05/07/2026

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Directions to “ KENNETH LESSENBERRY MD” Practice Location

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