Provider Demographics
NPI:1316952898
Name:CANANT, KENNETH E (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:E
Last Name:CANANT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1200 POWELL STREET SUITE 900
Mailing Address - Street 2:TAKIYAH HARPER MEDAMERICA
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608
Mailing Address - Country:US
Mailing Address - Phone:510-350-2732
Mailing Address - Fax:510-597-9200
Practice Address - Street 1:811 E PARRISH AVE
Practice Address - Street 2:
Practice Address - City:OWENSBORO
Practice Address - State:KY
Practice Address - Zip Code:42303-3258
Practice Address - Country:US
Practice Address - Phone:270-685-0216
Practice Address - Fax:270-685-0863
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY31448207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64314487Medicaid
KYE17035Medicare UPIN
KY0044116Medicare ID - Type Unspecified