Individual
DR. MICHAEL F KENNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
938 W MAIN ST, SUITE 2, HILLSBORO, OH 45133-7484
(937) 393-4390
(937) 393-4640
Mailing address
938 W MAIN ST, SUITE 2, HILLSBORO, OH 45133-7484
(937) 393-4390
(937) 393-4640
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
34004486
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0688671
—
OH
01
—
2355062
RHC MEDICAID CLINIC #
OH
01
—
311674981
OTHER FACILITY TAX ID #
OH
01
—
363843
RHC MEDICARE CLINIC #
OH
01
—
P00665503
MEDICARE RR
OH
Enumeration date
08/17/2005
Last updated
08/29/2011
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