Healthcare Provider Details

I. General information

NPI: 1255302907
Provider Name (Legal Business Name): KENNETH S SALHANY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2006
Last Update Date: 05/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

236 NORTH MAIN STREET
LOBELVILLE TN
37097
US

IV. Provider business mailing address

236 NORTH MAIN ST PO BOX 219
LOBELVILLE TN
37097
US

V. Phone/Fax

Practice location:
  • Phone: 931-593-2277
  • Fax: 931-593-2517
Mailing address:
  • Phone: 931-593-2277
  • Fax: 931-593-2517

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number648
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD00000000648
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: