Provider Demographics
NPI:1942417936
Name:KEARNS, KENNETH (MD)
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:
Last Name:KEARNS
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 1:950 PULASKI DR STE 100
Mailing Address - Street 2:
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-2802
Mailing Address - Country:US
Mailing Address - Phone:610-768-5940
Mailing Address - Fax:610-768-5947
Practice Address - Street 1:950 PULASKI DR STE 100
Practice Address - Street 2:
Practice Address - City:KING OF PRUSSIA
Practice Address - State:PA
Practice Address - Zip Code:19406-2802
Practice Address - Country:US
Practice Address - Phone:610-768-5940
Practice Address - Fax:610-768-5947
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD437656207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3944055000OtherINDEPENDENCE BLUE CROSS
PA482950Medicare PIN