Individual
KENNETH W STARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6419 BRISTOL HWY, PINEY FLATS, TN 37686-5208
(423) 538-5202
(423) 538-8208
Mailing address
6419 BRISTOL HWY, PINEY FLATS, TN 37686-5208
(423) 538-5202
(423) 538-8208
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
11023
GA
363A00000X
Physician Assistant
PA1414
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1506303
—
TN
01
—
P0141826
RR MDCR
TN
Enumeration date
10/10/2006
Last updated
07/20/2022
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