Individual
DR. KENNETH JAY MARKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
131 N JEFFERSON ST NE, MILLEDGEVILLE, GA 31061-5513
(478) 445-4817
(478) 445-4817
Mailing address
131 N JEFFERSON ST NE, MILLEDGEVILLE, GA 31061-5513
(478) 445-4817
(478) 445-0963
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
035293
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP1997
MEDICARE ORGANIZATION PTAN
GA
01
—
GRP2030
MEDICARE ORGANIZATION PTAN
GA
Enumeration date
01/31/2006
Last updated
08/31/2009
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