Individual
DAVID KENNETH FENNER
Active
Individual
DAVID KENNETH FENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
170100000X
Ph.D. Medical Genetics
MD0000008020
TN
207R00000X
Internal Medicine Physician
Primary
8020
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110147422
RAILROAD MEDICARE
TN
01
—
202731
BLUECROSS BLUESHIELD
TN
01
—
P01302537
RR MEDICARE
TN
05
—
Q002461
—
TN
01
—
TN0108
AMERICHOICE
TN
Enumeration date
09/28/2006
Last updated
12/17/2014
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