Civello, Kenneth Charles
Civello, Kenneth Charles is an individual health care provider with primary practice located at 7777 Hennessy Blvd Suite 1000, Baton Rouge LA 70808-4300. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology. Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology is his primary health care specialty. Civello, Kenneth Charles can be contacted via phone (225) 767-3900.Contact Information
Primary practice address
7777 Hennessy Blvd Suite 1000
Baton Rouge LA 70808-4300
Phone: (225) 767-3900
Fax: (225) 766-2226
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 201354 | Louisiana |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 35084798 | Ohio |
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 35084798 | Ohio |
| Allopathic & Osteopathic Physicians / Clinical Cardiac Electrophysiology | 207RC0001X | 201354 | Louisiana |
Profile Details
| NPI number | 1699745562 |
|---|---|
| LBN Legal business name | Civello, Kenneth Charles |
| Credentials | MD, MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 24th, 2006 |
| Last updated | Feb 11th, 2021 - about 4 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 | 1699745562 | NPPES |
| Ohio | Other | 1006122 | QUAL |
| Ohio | MEDICAID | 1108910 | QUAL |
| Ohio | Other | 114845 | QUAL |
| Ohio | Other | E84798 | QUAL |
| Ohio | Other | 000000364128 | QUAL |
| Ohio | Other | P00225594 | QUAL |
| Ohio | MEDICAID | 2515157 | QUAL |
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