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Kenneth Genova, MD
Specialist in Lagrange, Georgia
NPI 1548239148

Kenneth Genova is a Specialist based in Lagrange, GA. Kenneth Genova practices in Lagrange, GA and has the professional credentials of MD. The NPI Number for Kenneth Genova is 1548239148 and holds a License No. 036977 (Georgia).

The current practice location address for Kenneth Genova is 300 Medical Dr, Lagrange, GA and can be reached out via phone at 706-885-0111 and via fax at 706-885-0607. You can also correspond with Kenneth Genova through the mailing address at 300 MEDICAL DR, LAGRANGE, GA - 30240-4155 (mailing address contact number: 706-885-0111).

Location: 300 Medical Dr, Lagrange, GA, 30240-4155
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1548239148
Provider Name
Kenneth Genova
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
300 Medical Dr, Lagrange, GA, 30240-4155
Phone Number
706-885-0111
Fax Number
706-885-0607
Provider Enumeration Date
03/16/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
00542055A 05 GA
institution
Provider Business Practice Location Address Details
Address
300 Medical Dr
City
Lagrange
State
Georgia
Zip
30240-4155
Phone Number
706-885-0111
Fax Number
706-885-0607
person
Provider Business Mailing Address Details
Address
300 Medical Dr
City
Lagrange
State
Georgia
Zip
30240-4155
Phone Number
706-885-0111
Fax Number
706-885-0607
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
036977 (Georgia)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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