Provider Demographics
NPI:1568441673
Name:AKSU, KENAN (DO)
Entity Type:Individual
Prefix:
First Name:KENAN
Middle Name:
Last Name:AKSU
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:390 WATERLOO BLVD.
Mailing Address - Street 2:SUITE 200
Mailing Address - City:EXTON
Mailing Address - State:PA
Mailing Address - Zip Code:19341
Mailing Address - Country:US
Mailing Address - Phone:610-594-2009
Mailing Address - Fax:610-594-4780
Practice Address - Street 1:390 WATERLOO BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:EXTON
Practice Address - State:PA
Practice Address - Zip Code:19341-2603
Practice Address - Country:US
Practice Address - Phone:610-594-2009
Practice Address - Fax:610-594-4780
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS-008530L207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAG70754Medicare UPIN