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General NPI Number Information
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NPI Number | 1265847982
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Entity Type | Organization
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Legal Business Name | KENNETT HMA LLC
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Dates
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Enumeration Date | 06/23/2014
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Last Update Date | 11/10/2016
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Provider Practice Location Address
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Address Line | 509 SOUTH BYP
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City | KENNETT
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State | MO
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Zip | 63857-3248
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Country | US
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Telephone | 573-888-4310
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Fax | 573-888-0450
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Provider Business Mailing Address
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Address Line | PO BOX 689022
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City | FRANKLIN
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State | TN
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Zip | 37068-9022
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Country | US
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Telephone | 615-778-8532
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Fax | 615-628-6877
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Authorized Official
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Title or Position | DIRECTOR
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Name | MR. MICHAEL SWAW
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Credential |
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Telephone | 615-778-8076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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