Individual
DR. KENNETH B CAMACHO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1301 PLEASANT VALLEY RD STE 401, OWENSBORO, KY 42303-9774
(270) 417-7800
(270) 417-7809
Mailing address
PO BOX 365, MORTON, IL 61550-0365
(309) 672-4980
(309) 671-2944
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
036101777
IL
207RG0100X
Gastroenterology Physician
57390
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036101777
—
IL
01
—
067597
HEALTH ALLIANCE
IL
01
—
07215152
BLUE CROSS
IL
01
—
100014760
RAILROAD MEDICARE
IL
01
—
371221637
FEDERAL TAX ID
IL
01
—
426249
HEALTHLINK
IL
01
—
7036279
AETNA HEALTH PLANS
IL
05
—
7100877910
—
KY
01
—
776530
MEDICARE GROUP NUMBER
IL
01
—
IL0114
JOHN DEERE
IL
Enumeration date
06/10/2006
Last updated
06/26/2023
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