Individual
DR. KENNETH L HAILE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
320 KENNESTONE HOSPITAL BLVD STE LL1, MARIETTA, GA 30060-1166
(770) 793-7500
(770) 793-7985
Mailing address
PO BOX 3333, MARIETTA, GA 30061-3333
(770) 793-7500
(770) 793-7985
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
020723
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00198448C
—
GA
Enumeration date
01/11/2007
Last updated
07/08/2007
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