| Kenneth E. Dinella Md Llc | |
|
1120 Elm Ave Americus GA 31709-4253 | |
| (229) 928-8868 | |
| (229) 928-8919 |
| Full Name | Kenneth E. Dinella Md Llc |
|---|---|
| Speciality | Psychiatry & Neurology - Psychiatry |
| Location | 1120 Elm Ave, Americus, Georgia |
| Authorized Official Name and Position | Kenneth Edward Dinella (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2299288868 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth E. Dinella Md Llc Po Box 686 Americus GA 31709-0686 Ph: (229) 928-8868 | Kenneth E. Dinella Md Llc 1120 Elm Ave Americus GA 31709-4253 Ph: (229) 928-8868 |
| NPI Number | 1750625364 |
|---|---|
| Provider Enumeration Date | 11/20/2012 |
| Last Update Date | 11/20/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750625364 | NPI | - | NPPES |
| 00553253A | Medicaid | GA | |
| 26BDCVB | Other | GA | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 036716 (Georgia) | Primary |
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