Individual
MR. KENNETH M HAINSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
M8605
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010138765
BLUE SHIELD
ID
01
—
000010138766
BLUE SHIELD
ID
01
—
180044930
RAILROAD MEDICARE
ID
01
—
48801
BLUE CROSS
ID
05
—
806365500
—
ID
01
—
J6576
BLUE CROSS
ID
Enumeration date
10/21/2005
Last updated
06/12/2024
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