Provider Demographics
NPI:1699806166
Name:POLLARD, KENNETH H (MA)
Entity Type:Individual
Prefix:MR
First Name:KENNETH
Middle Name:H
Last Name:POLLARD
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3759 VINEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31204-1854
Mailing Address - Country:US
Mailing Address - Phone:478-477-7700
Mailing Address - Fax:478-477-0200
Practice Address - Street 1:3759 VINEVILLE AVE
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31204-1854
Practice Address - Country:US
Practice Address - Phone:478-477-7700
Practice Address - Fax:478-477-0200
Is Sole Proprietor?:No
Enumeration Date:2007-03-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAUD0076231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist