Individual
KENNETH GENE DENNISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
530 S JACKSON ST, LOUISVILLE, KY 40202-1675
(502) 852-6395
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0320
(502) 588-0326
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25085
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64250855
—
KY
Enumeration date
08/02/2006
Last updated
06/17/2016
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