Individual
KENNETH E. ROSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2410 AVALON AVE, MUSCLE SHOALS, AL 35661-3283
(256) 386-0808
(256) 389-8904
Mailing address
2410 AVALON AVE STE B, MUSCLE SHOALS, AL 35661-3284
(256) 386-0809
(256) 383-8000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21078
AL
207R00000X
Internal Medicine Physician
K8461
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116304002
—
TX
01
—
58815
MEDICARE
AL
Enumeration date
09/08/2005
Last updated
07/24/2024
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