| Kenneth J Headen Md Pa | |
|
806 Summit Ave 210a Greensboro NC 27405-7861 | |
| (336) 279-1227 | |
| (336) 279-1226 |
| Full Name | Kenneth J Headen Md Pa |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 806 Summit Ave, Greensboro, North Carolina |
| Authorized Official Name and Position | Kenneth Jay Headen (MD/CEO) |
| Authorized Official Contact | 3362791227 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kenneth J Headen Md Pa 806 Summit Ave Ste 210a Greensboro NC 27405-7861 Ph: (336) 279-1227 | Kenneth J Headen Md Pa 806 Summit Ave 210a Greensboro NC 27405-7861 Ph: (336) 279-1227 |
| NPI Number | 1780935395 |
|---|---|
| Provider Enumeration Date | 09/21/2012 |
| Last Update Date | 09/21/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780935395 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 9400266 (North Carolina) | Primary |
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