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General NPI Number Information
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NPI Number | 1366568719
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Entity Type | Organization
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Legal Business Name | E. WILLIAM KENNEN ORTHOPAEDICS,PC
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 870 WEATHERWOOD LN STE 4
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City | GREENSBURG
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State | PA
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Zip | 15601-5777
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Country | US
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Telephone | 724-838-0966
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Fax | 724-838-0970
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Provider Business Mailing Address
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Address Line | 870 WEATHERWOOD LN STE 4
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City | GREENSBURG
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State | PA
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Zip | 15601-5777
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Country | US
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Telephone | 724-838-0966
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Fax | 724-838-0970
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Authorized Official
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Title or Position | PRESIDENT
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Name | EUGENE WILLIAM KENNEN
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Credential | DO
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Telephone | 724-838-0966
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | OS-005811-L
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License Number State | PA
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