Provider Demographics
NPI:1013486638
Name:K E MANAGEMENT SERVICES
Entity Type:Organization
Organization Name:K E MANAGEMENT SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:FUOCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:504-495-6772
Mailing Address - Street 1:PO BOX 170
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:AR
Mailing Address - Zip Code:72949-0170
Mailing Address - Country:US
Mailing Address - Phone:866-243-7203
Mailing Address - Fax:866-243-7203
Practice Address - Street 1:1420 E AUGUSTINE LN STE 7
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4995
Practice Address - Country:US
Practice Address - Phone:479-200-9812
Practice Address - Fax:866-243-7203
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:K E MANAGEMENT SERVICES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-11-14
Last Update Date:2018-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty