MR. KENNETH BANNON, BSPA-C

Physician Assistant

Active Individual
NPI: 1821055047

Practice Address

111 SALEM AVENUE
SUITE 302
Carbondale, PA 18407

Phone: (570) 282-2031

Specialties

Specialty Code Primary License
Physician Assistant 363A00000X Yes MA001023L (PA)

Frequently Asked Questions

NPI 1821055047 is the National Provider Identifier for MR. KENNETH BANNON, BSPA-C, a Physician Assistant provider located in Carbondale, PA. This NPI was enumerated on May 1, 2006.
MR. KENNETH BANNON, BSPA-C practices at 111 SALEM AVENUE, SUITE 302, Carbondale, PA 18407.

Quick Facts

NPI
1821055047
Type
Individual
Enumerated
May 1, 2006
Last Updated
Mar 23, 2015

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