Individual
KENNETH ALLEN GADDIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
010208
LA
2084N0400X
Neurology Physician
Primary
MD.010208
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00786760
—
MS
05
—
1117587
—
LA
Enumeration date
05/19/2006
Last updated
01/28/2013
Update your record
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