Mekelburg, Kenneth John
Mekelburg, Kenneth John is an individual health care provider with primary practice located at 2525 Viking Drive , Bossier City LA 71111-2103. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mekelburg, Kenneth John can be contacted via phone (318) 841-2525.Contact Information
Primary practice address
2525 Viking Drive
Bossier City LA 71111-2103
Phone: (318) 841-2525
Fax: (318) 681-6812
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 13801R | Louisiana |
Profile Details
NPI number | 1619975166 |
---|---|
LBN Legal business name | Mekelburg, Kenneth John |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 8th, 2005 |
Last updated | Mar 29th, 2012 - about 13 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 | 1619975166 | NPPES |
Louisiana | MEDICAID | 1436836 |
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