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NPI Code Detail

MEDICARE: KENNETH I ATAGA MD

MEDICARE: KENNETH I ATAGA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0003XHematology & Oncology Physician57803TN
2207RH0003XHematology & Oncology Physician9700849NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1306886825
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH I ATAGA MD
Provider Business Mailing Address
First Line : 1211 UNION AVE STE 330
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-6655
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1265 UNION AVE
Second Line :
City : MEMPHIS
State : TN
Zip : 38104-3415
Country : US
Telephone Number : 901-478-2760
Fax Number : 901-478-8358
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/07/2006
Last Update Date : 04/20/2026

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Directions to “ KENNETH I ATAGA MD” Practice Location

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