Provider Demographics
NPI:1689012940
Name:TENNY, STEVEN O (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:O
Last Name:TENNY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 S SANTA FE AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4189
Mailing Address - Country:US
Mailing Address - Phone:785-823-1032
Mailing Address - Fax:785-452-7807
Practice Address - Street 1:501 S SANTA FE AVE STE 300
Practice Address - Street 2:
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-4189
Practice Address - Country:US
Practice Address - Phone:785-823-1032
Practice Address - Fax:785-452-7807
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-10
Last Update Date:2021-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE32489207T00000X
SD12100207T00000X
TXS6753207T00000X
NE6951207T00000X
KS04-42910207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201288070AMedicaid