Provider Demographics
NPI:1174510598
Name:KRESS, KENNETH J (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:J
Last Name:KRESS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:3400 OLD MILTON PKWY STE C290
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-6491
Mailing Address - Country:US
Mailing Address - Phone:770-667-4343
Mailing Address - Fax:770-772-0937
Practice Address - Street 1:3400 OLD MILTON PKWY STE C290
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-6491
Practice Address - Country:US
Practice Address - Phone:770-667-4343
Practice Address - Fax:770-772-0937
Is Sole Proprietor?:No
Enumeration Date:2005-09-30
Last Update Date:2022-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA032768207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003161408FMedicaid
GA003161408EMedicaid
GA003161408GMedicaid
GA202I209712Medicare PIN