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NPI 1801950530

NPI 1801950530 : KENNETH M EUGENE MD : RINCON, GA

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General NPI Number Information
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    NPI Number           |    1801950530
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    Entity Type          |    Individual 
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    Provider Name        |    KENNETH M EUGENE MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    12/20/2006
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    Last Update Date     |    02/28/2017
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Provider Practice Location Address
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    Address Line         |    423 S. COLUMBIA AVENUE 
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    City                 |    RINCON
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    State                |    GA
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    Zip                  |    31326-1399
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    Country              |    US
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    Telephone            |    912-826-8860
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    Fax                  |    912-826-2813
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Provider Business Mailing Address
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    Address Line         |    602 E 72ND ST 
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    City                 |    SAVANNAH
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    State                |    GA
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    Zip                  |    31405-4913
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    Country              |    US
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    Telephone            |    912-819-7878
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    Fax                  |    912-819-7850
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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        |    207Q00000X
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    Taxonomy Name        |    Family Medicine Physician
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    License Number       |    GA035866
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    License Number State |    GA
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