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Individual

JAMES G KANNENBERG

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
5409 AVENUE O, FORT MADISON, IA 52627-9601
(319) 376-2134
(319) 376-2188
Mailing address
5409 AVENUE O, FORT MADISON, IA 52627-9601
(319) 376-2134
(319) 376-2188

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22910
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1194928
IA
01
25668
IOWA HEALTH SOLUTIONS
IA
01
45020
WELLMARK BLUE CROSS
IA
01
IA0122
JOHN DEERE HEALTH
IA
Enumeration date
08/12/2005
Last updated
08/01/2007
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