Individual
MR. KENNETH J RENNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1263 HOSPITAL DR NW, SUITE 105, CORYDON, IN 47112-2172
(812) 734-3800
(812) 734-3801
Mailing address
1263 HOSPITAL DR NW, SUITE 105, CORYDON, IN 47112-2172
(812) 734-3800
(812) 734-3801
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
01065830A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036093301
—
IL
Enumeration date
09/20/2006
Last updated
12/15/2014
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