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General NPI Number Information
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NPI Number | 1437114725
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Entity Type | Individual
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Provider Name | KENNA S. GIVEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/19/2006
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Last Update Date | 11/19/2007
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Provider Practice Location Address
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Address Line | 1120 15TH ST
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City | AUGUSTA
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State | GA
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Zip | 30912-0004
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Country | US
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Telephone | 706-721-2198
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Fax | 706-721-5748
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Provider Business Mailing Address
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Address Line | 748 TRIPPS CT
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City | AUGUSTA
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State | GA
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Zip | 30909-1816
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 013847
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License Number State | GA
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