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General NPI Number Information
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NPI Number | 1922074657
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Entity Type | Individual
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Provider Name | PAUL KENNETH BIRNEY M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/23/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 650 JOEL DR BLANCHFIELD ARMY COMMUNITY HOSPITAL
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City | FORT CAMPBELL
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State | KY
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Zip | 42223-5318
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Country | US
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Telephone | 270-956-0138
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Fax |
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Provider Business Mailing Address
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Address Line | 141 ROSE DR
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City | DOVER
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State | TN
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Zip | 37058-3061
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Country | US
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Telephone | 931-232-0010
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD0000040292
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License Number State | TN
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