Individual
MR. KIM PIERSON KORNEGAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
711 KORNEGAY DRIVE, SUITE A, PRATTVILLE, AL 36066-7715
(334) 285-7111
(334) 285-3310
Mailing address
711 KORNEGAY DRIVE, SUITE A, PRATTVILLE, AL 36066-7715
(334) 285-7111
(334) 285-3310
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
CS3863
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
776896
UNITED CONCORDIA
AL
01
—
90076
BLUE CROSS BLUE SHIELD
AL
Enumeration date
08/29/2006
Last updated
07/08/2007
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