Individual
DR. KEVIN R BANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1200 S CEDAR CREST BLVD, ALLENTOWN, PA 18103
(610) 402-8088
Mailing address
1255 S CEDAR CREST BLVD, SUITE 3600, ALLENTOWN, PA 18103-6256
(610) 770-1606
(610) 740-0560
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
MD070875L
PA
2085R0202X
Diagnostic Radiology Physician
Primary
MD070785L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0018060670001
—
PA
Enumeration date
01/23/2006
Last updated
11/06/2018
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