Organization
CLEARFORK ANESTHESIA ASSOCIATES, PLLC
Active
Organization
CLEARFORK ANESTHESIA ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY KENESON D.O. (OWNER/PHYSICIAN)
(765) 284-0493
Entity
Organization
Contact information
Practice address
6311 SOUTHWEST BLVD, BENBROOK, TX 76132-1063
(817) 731-2795
Mailing address
PO BOX 1889, MUNCIE, IN 47308-1889
(765) 284-0493
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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