Individual
KENNETH J REED
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.C.
Contact information
Practice address
131 HOSPITAL LN, JELLICO, TN 37762-4404
(423) 784-7269
(423) 784-3708
Mailing address
PO BOX 447, JELLICO, TN 37762-0447
(423) 784-7269
(423) 784-3708
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA0000000105
TN
363AM0700X
Medical Physician Assistant
PA272
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1522588
—
TN
Enumeration date
10/12/2006
Last updated
01/18/2017
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