Provider Demographics
NPI:1619941747
Name:MORE, KENNETH FRANCIS (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:FRANCIS
Last Name:MORE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5900 LAKE WRIGHT DR
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-1871
Mailing Address - Country:US
Mailing Address - Phone:757-466-8683
Mailing Address - Fax:757-466-8892
Practice Address - Street 1:1950 GLENN MITCHELL DR
Practice Address - Street 2:SUITE 102
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23456-0019
Practice Address - Country:US
Practice Address - Phone:757-368-0437
Practice Address - Fax:757-368-0492
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101053645207RH0003X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA1619941747Medicaid
VAP01373557OtherRAILROAD MEDICARE
VAVVB573AMedicare PIN