Provider Demographics
NPI:1275691073
Name:KINNEY, STEVEN ROSS (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:ROSS
Last Name:KINNEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:244 JACKSON MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:HERMITAGE
Mailing Address - State:TN
Mailing Address - Zip Code:37076-1425
Mailing Address - Country:US
Mailing Address - Phone:615-874-9888
Mailing Address - Fax:615-883-6899
Practice Address - Street 1:244 JACKSON MEADOWS DR
Practice Address - Street 2:
Practice Address - City:HERMITAGE
Practice Address - State:TN
Practice Address - Zip Code:37076-1425
Practice Address - Country:US
Practice Address - Phone:615-874-9888
Practice Address - Fax:615-883-6899
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN012856207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3189715Medicare PIN
TNB04392Medicare UPIN