Provider Demographics
NPI:1851437669
Name:KIENER, JOSEPH LEO (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:LEO
Last Name:KIENER
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:PO BOX 21609
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89721-1609
Mailing Address - Country:US
Mailing Address - Phone:775-884-2455
Mailing Address - Fax:775-884-0345
Practice Address - Street 1:530 HAMMILL LN
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2045
Practice Address - Country:US
Practice Address - Phone:775-825-1234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV6269208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVMD6269Medicare ID - Type Unspecified