Provider Demographics
NPI:1023033917
Name:SAAG, KENNETH
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:SAAG
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1717 6TH AVE S
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35233-1801
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1717 6TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1801
Practice Address - Country:US
Practice Address - Phone:800-822-8816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22153207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000011744Medicaid
AL051011744OtherBLUE CROSS
AL42839OtherHEALTHSPRING OF ALABAMA
AL000011744OtherBLUE CROSS
AL12780OtherHEALTHSPRING OF ALABAMA
AL051008019OtherBLUE CROSS
LA1413607OtherEMERGENCY LA MEDICAID
AL000008019OtherBLUE CROSS
AL000008019Medicaid
ALE19280OtherVIVA
AL12780OtherHEALTHSPRING OF ALABAMA
ALE19280OtherVIVA
AL000011744Medicare PIN