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Individual

DR. KENNETH F. MENCHION

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
350 COUNTRY CLUB DR, SUITE A, STOCKBRIDGE, GA 30281-9084
(770) 692-4000
(770) 474-8510
Mailing address
350 COUNTRY CLUB DR, SUITE A, STOCKBRIDGE, GA 30281-9084
(770) 692-4000
(770) 474-8510

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
047236
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000821378D
GA
Enumeration date
04/25/2006
Last updated
09/24/2020
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