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General NPI Number Information
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NPI Number | 1922033281
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Entity Type | Individual
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Provider Name | KENNETH JEFF CARNEY M.D., PHARMD
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Gender | Male
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Dates
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Enumeration Date | 07/12/2006
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Last Update Date | 05/16/2022
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Provider Practice Location Address
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Address Line | 3193 HOWELL MILL RD NW STE 322
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City | ATLANTA
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State | GA
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Zip | 30327-2100
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Country | US
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Telephone | 470-788-8379
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Fax |
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Provider Business Mailing Address
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Address Line | 955 CLIFTON RD NE
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City | ATLANTA
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State | GA
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Zip | 30307-1225
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Country | US
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Telephone | 404-593-1176
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 050349
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License Number State | GA
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