# KENNETH BANKS MD PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kenneth Banks MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1679804116
- **Authorized official:** KENNETH BANKS MD (OWNER)
- **Authorized official phone:** (919) 269-9144

## Contact information

- **Practice address:** 2949 NEW BERN AVENUE, SUITE 112A, RALEIGH, NC 27610
- **Practice address phone:** (919) 255-1408
- **Practice address fax:** (919) 212-9029
- **Mailing address:** PO BOX 707, DURHAM, NC 27702-0707
- **Mailing address phone:** (919) 255-1408
- **Mailing address fax:** (919) 212-9029

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 18602 | NC | Yes |

## Other

- **Enumeration date:** 01/22/2010
- **Last updated:** 12/20/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 8912978 | — | NC |