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General NPI Number Information
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NPI Number | 1396751087
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Entity Type | Organization
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Legal Business Name | KENNETH ISRAEL M.D. P.C.
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Dates
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Enumeration Date | 08/01/2006
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Last Update Date | 07/29/2008
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Provider Practice Location Address
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Address Line | 26111 W 14 MILE RD SUITE LL2
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City | FRANKLIN
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State | MI
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Zip | 48025-1168
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Country | US
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Telephone | 248-851-1159
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Fax | 248-851-2478
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Provider Business Mailing Address
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Address Line | 26111 W 14 MILE RD SUITE LL2
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City | FRANKLIN
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State | MI
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Zip | 48025-1168
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Country | US
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Telephone | 248-851-1159
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Fax | 248-851-2478
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH ISRAEL
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Credential | M.D.
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Telephone | 248-851-1159
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 020499
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License Number State | MI
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