Provider Demographics
NPI:1174663926
Name:EAR NOSE & THROAT CONSULTANTS & HEARING SERVICES PC
Entity Type:Organization
Organization Name:EAR NOSE & THROAT CONSULTANTS & HEARING SERVICES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:KENNY
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:712-252-5203
Mailing Address - Street 1:956 PEBBLE BEACH DR
Mailing Address - Street 2:
Mailing Address - City:DAKOTA DUNES
Mailing Address - State:SD
Mailing Address - Zip Code:57049-5107
Mailing Address - Country:US
Mailing Address - Phone:605-422-1080
Mailing Address - Fax:712-252-0512
Practice Address - Street 1:2730 PIERCE ST
Practice Address - Street 2:SUITE 402
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51104-3796
Practice Address - Country:US
Practice Address - Phone:712-252-5203
Practice Address - Fax:712-252-0512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty