Individual
DR. KENNETH EDWARD DINELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1120 ELM AVE, AMERICUS, GA 31709
(229) 928-8868
(229) 928-8919
Mailing address
PO BOX 686, AMERICUS, GA 31709-0686
(229) 928-8868
(229) 928-8919
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
36716
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00553253A
—
GA
01
—
36716
STATE LICENSE NUMBER
GA
Enumeration date
04/17/2007
Last updated
03/07/2023
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