Individual
DR. KELLEN THOMAS BANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2213 CHERRY ST, TOLEDO, OH 43608-2603
(419) 251-4724
Mailing address
1901 CLINCH AVE, KNOXVILLE, TN 37916-2307
(313) 674-0200
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2855
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649535279
—
TN
Enumeration date
07/10/2012
Last updated
10/25/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us