Chan, Kenneth
Chan, Kenneth is an individual health care provider with primary practice located at 4802 E Johnson Ave , Jonesboro AR 72401-8413. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Chan, Kenneth can be contacted via phone (870) 936-8000.Contact Information
Primary practice address
4802 E Johnson Ave
Jonesboro AR 72401-8413
Phone: (870) 936-8000
Fax: (870) 934-3635
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | E-0805 | Arkansas |
Profile Details
| NPI number | 1720042138 |
|---|---|
| LBN Legal business name | Chan, Kenneth |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 13th, 2006 |
| Last updated | Jan 4th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720042138 | NPPES |
| Arkansas | MEDICAID | 129976003 |
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