Cleveland, Kenneth E
Cleveland, Kenneth E is an individual health care provider with primary practice located at 1190 North State Street Suite 502, Jackson MS 39202. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Cleveland, Kenneth E can be contacted via phone (601) 944-1781.Contact Information
Primary practice address
1190 North State Street Suite 502
Jackson MS 39202
Phone: (601) 944-1781
Fax: (601) 353-0439
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 15419 | Mississippi |
Profile Details
| NPI number | 1639266406 |
|---|---|
| LBN Legal business name | Cleveland, Kenneth E |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1639266406 | NPPES |
| Mississippi | MEDICAID | 00123961 |
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