Organization
PAUL S KENYON, MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL S KENYON MD (PRESIDENT)
(517) 787-6924
Entity
Organization
Contact information
Practice address
150 S EAST AVE, JACKSON, MI 49201-2412
(517) 787-6924
(517) 787-8335
Mailing address
PO BOX 600, JACKSON, MI 49204-0600
(517) 787-6924
(517) 787-8335
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
49140
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0380337
BCBSM
MI
05
—
2572436
—
MI
Enumeration date
04/29/2008
Last updated
01/04/2010
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