MEDICARE: DR. KENNETH EDWARD NESS

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
1	207R00000X	Internal Medicine Physician	ME73980	FL
2	207RI0200X	Infectious Disease Physician	ME73980	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1437100237
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH EDWARD NESS

Provider Business Mailing Address
First Line	:	1311 N MILDRED RD
Second Line	:
City	:	CORTEZ
State	:	CO
Zip	:	81321-2231
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1311 N MILDRED RD
Second Line	:
City	:	CORTEZ
State	:	CO
Zip	:	81321-2231
Country	:	US
Telephone Number	:	970-565-6666
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2006
Last Update Date	:	11/07/2019

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