Healthcare Provider Details

I. General information

NPI: 1114010725
Provider Name (Legal Business Name): KENNETH V. AKEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 03/17/2026
Certification Date: 03/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

172 HILLCREST OVERLOOK
NEWNAN GA
30265-2639
US

IV. Provider business mailing address

172 HILLCREST OVERLOOK
NEWNAN GA
30265-2639
US

V. Phone/Fax

Practice location:
  • Phone: 949-633-4008
  • Fax: 770-683-3019
Mailing address:
  • Phone: 770-683-3020
  • Fax: 833-341-1131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMED-PHYS-LIC-91321
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA26103
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number78448
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: