Basic Information
| Provider Information | |||||||||
| NPI: | 1760624936 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | KENAN | ||||||||
| FirstName: | DANIEL | ||||||||
| MiddleName: | JAMES | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 10810 EXECUTIVE CENTER DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722114386 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016042695 | ||||||||
| FaxNumber: | 5016042699 | ||||||||
| Practice Location | |||||||||
| Address1: | 10810 EXECUTIVE CENTER DR STE 100 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722114386 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016042695 | ||||||||
| FaxNumber: | 5016042699 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2009 | ||||||||
| LastUpdateDate: | 01/19/2017 | ||||||||
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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 | 207ZP0102X | 9700307 | NC | Y | Allopathic & Osteopathic Physicians | Pathology | Anatomic Pathology & Clinical Pathology |
No ID Information.