Individual
DR. MAX CALVIN KINNAMAN JR.
Active
Individual
DR. MAX CALVIN KINNAMAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
02306
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0257
MEDICARE GROUP
KY
05
—
30604011
—
KY
05
—
64023062
—
KY
Enumeration date
01/12/2007
Last updated
03/24/2020
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