Individual
MR. KENNY JOE MANION
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
411 S L ROGER WELLS BLVD, GLASGOW, KY 42141-1191
(270) 651-7796
(270) 651-7074
Mailing address
411 S L ROGER WELLS BLVD, GLASGOW, KY 42141-1191
(270) 651-7796
(270) 651-7074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
24806
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64248065
—
KY
Enumeration date
09/01/2005
Last updated
02/02/2024
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