Individual
DR. MAX CALVIN KINNAMAN JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
380 SUWANNEE TRAIL ST, BOWLING GREEN, KY 42103-7956
(270) 901-5000
(270) 842-5268
Mailing address
380 SUWANNEE TRAIL ST, BOWLING GREEN, KY 42103-7956
(270) 901-5000
(270) 842-5268
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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