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Individual
KENNETH L POAG
Active
Individual
KENNETH L POAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
8286
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3089723
STONES RIVER IPA
TN
05
—
3155534
—
TN
01
—
4040148
BCBS
TN
01
—
64745870
KY MEDICAID
KY
Enumeration date
07/07/2006
Last updated
07/07/2009
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