Individual
GREG KENNEBECK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
222 PIEDMONT AVE, STE. 6000, CINCINNATI, OH 45219-4231
(513) 475-7880
(513) 475-8766
Mailing address
PO BOX 636256 CENTRAL CREDENTIALING, CINCINNATI, OH 45263-6256
(513) 585-5501
(513) 585-5511
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35080848K
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200376210
—
IN
05
—
2308461
—
OH
05
—
64049067
—
KY
Enumeration date
04/11/2006
Last updated
01/19/2018
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