Kenneth R Lattimore, MD
Individual provider Active NPI Psychiatry Physician · Montrose, PA
NPI 1962479055 · NPPES record last updated Jun 8, 2016
Key facts
- NPI
- 1962479055
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatry Physician 2084P0800X
- License
- MD035251E (PA)
- Practice address
- Lake Plaza 2 Route 706 E
Montrose, PA 18801-0285 - Phone
- (570) 278-3393
- Fax
- (570) 278-1716
- NPI assigned
- Mar 7, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Tri County Human Services Center Inc | Past | Accepting new patients | |
| Tri County Human Services Center Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | MD035251E | PA | Yes |
Addresses
Primary practice location
Lake Plaza 2 Route 706 E
Montrose, PA 18801-0285
Mailing address
185 Fallbrook St
Carbondale, PA 18407-0514
Phone (570) 282-1732
Other providers in Montrose, PA
- Heather Lynn Kesler
- Hassan Y Khalil
- John Kielbasa
- Abigail Klase
- Katie Michele Kronyak
- Cheryl Leonard
- Ann Lewis
- Ann Marie Lewis
- LPS Home Physical Therapy Services LLC
- Jacqueline A Magdin
All providers in Montrose, PA · Psychiatry Physician in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 8, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.