Provider Demographics
NPI:1902187479
Name:CAIL, KENNETH HILLMAN III
Entity Type:Individual
Prefix:
First Name:KENNETH
Middle Name:HILLMAN
Last Name:CAIL
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4700 WATER AVE
Mailing Address - Street 2:INTERNAL MEDICINE EDUCATION
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404
Mailing Address - Country:US
Mailing Address - Phone:912-350-0583
Mailing Address - Fax:
Practice Address - Street 1:503 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2668
Practice Address - Country:US
Practice Address - Phone:912-355-6255
Practice Address - Fax:912-355-6256
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-29
Last Update Date:2021-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2020-006132085R0202X
390200000X
GA882182085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program