Individual
KENNETH L POAG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2001 MALLORY LN, FRANKLIN, TN 37067-8233
(615) 771-1940
(615) 771-1984
Mailing address
2001 MALLORY LN, SUITE 103, FRANKLIN, TN 37067-8233
(615) 771-1940
(615) 771-1984
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
8286
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3089723
STONES RIVER IPA
TN
05
—
3155534
—
TN
01
—
4040148
BCBS
TN
01
—
64745870
KY MEDICAID
KY
Enumeration date
07/07/2006
Last updated
07/07/2009
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