Individual
KENNETH WAYNE DUNAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4550 NORTH BLVD, SUITE 100, BATON ROUGE, LA 70806-4013
(225) 938-6239
(225) 926-3346
Mailing address
10141 SANDHILL CT, BATON ROUGE, LA 70809-5924
(225) 938-6239
(225) 926-3346
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PAA10576RX
LA
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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