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Individual

KENNETH L PEREGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
601 KEYSER AVE, NATCHITOCHES, LA 71457-6020
(318) 214-5770
Mailing address
PO BOX 2475, NATCHITOCHES, LA 71457-2475
(318) 214-5770

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
K1758
TX
208800000X
Urology Physician
Primary
L14007R
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0280850001
CIGNA-GOVERMENT
LA
05
1199729
LA
Enumeration date
02/09/2006
Last updated
11/11/2025
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