Individual
KENNETH DISBROW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
49 JESSE HILL JR DR SE, ATLANTA, GA 30303-3049
(404) 251-8865
(404) 688-6355
Mailing address
1540 GREGORY AVE, UNION, NJ 07083-5542
(908) 612-0587
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
81606
GA
Other
Enumeration date
03/31/2017
Last updated
08/12/2021
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