Organization
MICHAEL D KENNER, MD,PC
Active
Other names
none
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL DAVID KENNER MD (DOCTOR/OWNER)
(208) 453-1062
Entity
Organization
Contact information
Practice address
1721 S 10TH AVE, CALDWELL, ID 83605-4839
(208) 453-1062
(208) 453-1196
Mailing address
1721 S 10TH AVE, CALDWELL, ID 83605-4839
(208) 453-1062
(208) 453-1196
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Enumeration date
07/23/2007
Last updated
07/23/2007
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