Individual
DR. PETER KINNEBREW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
13596 HWY 231 431 N, SUITE 2, HAZEL GREEN, AL 35750-8642
(256) 828-2094
(256) 828-0526
Mailing address
13596 HWY 231 431 N, SUITE 2, HAZEL GREEN, AL 35750-8617
(256) 828-2094
(256) 828-0526
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
22185
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009981810
—
AL
01
—
51045542
BCBS
AL
Enumeration date
01/04/2006
Last updated
09/03/2010
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