Provider Demographics
NPI:1366568719
Name:E. WILLIAM KENNEN ORTHOPAEDICS,PC
Entity type:Organization
Organization Name:E. WILLIAM KENNEN ORTHOPAEDICS,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:EUGENE
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KENNEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:724-838-0966
Mailing Address - Street 1:870 WEATHERWOOD LN
Mailing Address - Street 2:STE 4
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5777
Mailing Address - Country:US
Mailing Address - Phone:724-838-0966
Mailing Address - Fax:724-838-0970
Practice Address - Street 1:870 WEATHERWOOD LN
Practice Address - Street 2:STE 4
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5777
Practice Address - Country:US
Practice Address - Phone:724-838-0966
Practice Address - Fax:724-838-0970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-005811-L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty