Provider Demographics
NPI:1376754218
Name:KENNETH J SABLE AND ASSOC INC
Entity Type:Organization
Organization Name:KENNETH J SABLE AND ASSOC INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER' DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:J
Authorized Official - Last Name:SABLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:301-645-5390
Mailing Address - Street 1:3261 OLD WASHINGTON RD
Mailing Address - Street 2:SUITE 2010
Mailing Address - City:WALDORF
Mailing Address - State:MD
Mailing Address - Zip Code:20602-3223
Mailing Address - Country:US
Mailing Address - Phone:301-645-5390
Mailing Address - Fax:301-645-6215
Practice Address - Street 1:3261 OLD WASHINGTON RD
Practice Address - Street 2:SUITE 2010
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20602-3223
Practice Address - Country:US
Practice Address - Phone:301-645-5390
Practice Address - Fax:301-645-6215
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-24
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDS01765111NX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NX0100XChiropractic ProvidersChiropractorOccupational HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDR726OtherBCBS DC'FED
MDM440OtherBCBS MD'NAT#
MD378QMedicare PIN
MDR726OtherBCBS DC'FED