Individual
KENNETH TODD PIERCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD0000040857
TN
2086S0129X
Vascular Surgery Physician
Primary
200500234
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200500234
LICENSE
NC
05
—
3338766
—
TN
01
—
MD0000040857
MEDICAL LICENSE
TN
Enumeration date
05/02/2006
Last updated
10/15/2014
Update your record
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