Individual
DR. KENNETH B FALLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
619 19TH ST S, P210 WEST PAVILION-UAB DEPARTMENT OF PATHOLOGY, BIRMINGHAM, AL 35233-1900
(205) 934-2164
(205) 975-7548
Mailing address
619 19TH ST S, P210 WEST PAVILION-UAB DEPARTMENT OF PATHOLOGY, BIRMINGHAM, AL 35233-1900
(205) 934-2164
(205) 975-7548
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
22385
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810005914
—
WV
01
—
P00354856
RAILROAD MEDICARE
WV
Enumeration date
08/19/2006
Last updated
12/06/2016
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