Basic Information
| Provider Information | |||||||||
| NPI: | 1689012940 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TENNY | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | O | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 501 S SANTA FE AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | SALINA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674014189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858231032 | ||||||||
| FaxNumber: | 7854527807 | ||||||||
| Practice Location | |||||||||
| Address1: | 501 S SANTA FE AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | SALINA | ||||||||
| State: | KS | ||||||||
| PostalCode: | 674014189 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7858231032 | ||||||||
| FaxNumber: | 7854527807 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2013 | ||||||||
| LastUpdateDate: | 01/28/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/28/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207T00000X | 32489 | NE | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 12100 | SD | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | S6753 | TX | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 6951 | NE | N | Allopathic & Osteopathic Physicians | Neurological Surgery | 207T00000X | 04-42910 | KS | Y | Allopathic & Osteopathic Physicians | Neurological Surgery |
ID Information
| ID | Type | State | Issuer | Description | 201288070A | 05 | KS | MEDICAID |