Individual
DR. KENNETH JOHN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 SW ARCHER RD, GAINESVILLE, FL 32610-4923
(139) 630-2147
Mailing address
593 EDDY ST, PROVIDENCE, RI 02903-4923
(401) 606-4286
(401) 444-5090
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
LP04885
RI
207L00000X
Anesthesiology Physician
Primary
ME168470
FL
207LC0200X
Critical Care Medicine (Anesthesiology) Physician
ME168470
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
122871900
—
FL
Enumeration date
05/28/2019
Last updated
09/05/2024
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