Basic Information
| Provider Information | |||||||||
| NPI: | 1346289543 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DENNY | ||||||||
| FirstName: | KEVIN | ||||||||
| MiddleName: | SCOTT | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 701 WILL HALSEY WAY | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 357582592 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2564617440 | ||||||||
| FaxNumber: | 2564617168 | ||||||||
| Practice Location | |||||||||
| Address1: | 701 WILL HALSEY WAY | ||||||||
| Address2: | |||||||||
| City: | MADISON | ||||||||
| State: | AL | ||||||||
| PostalCode: | 357582592 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2564617440 | ||||||||
| FaxNumber: | 2564617168 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/05/2006 | ||||||||
| LastUpdateDate: | 02/01/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | 14851 | AL | Y | Allopathic & Osteopathic Physicians | Pediatrics |
ID Information
| ID | Type | State | Issuer | Description | 4198641 | 01 | AL | AETNA | OTHER | 000083718 | 05 | AL | MEDICAID | 51083718 | 01 | AL | ALABAMA BLUE CROSS | OTHER | 0000120209603 | 01 | AL | UNITED HEALTHCARE | OTHER |