MEDICARE: DR. KENNETH J PAHREN M.D.

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	207Q00000X	Family Medicine Physician	01064537A	IN

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841295409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH J PAHREN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 223
Second Line	:
City	:	BATESVILLE
State	:	IN
Zip	:	47006-0223
Country	:	US
Telephone Number	:	812-933-5441
Fax Number	:	812-933-5446

Provider Business Practice Location Address
First Line	:	11137 US HIGHWAY 52
Second Line	:
City	:	BROOKVILLE
State	:	IN
Zip	:	47012-7901
Country	:	US
Telephone Number	:	765-647-5126
Fax Number	:	765-647-5900

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

Provider Enumeration Date	:	06/20/2005
Last Update Date	:	03/29/2021

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