Individual
KENT L KEBERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1307 ASTON AVE, MCCOMB, MS 39648-2898
(601) 684-8118
(601) 249-0846
Mailing address
1307 ASTON AVE, MCCOMB, MS 39648-2898
(601) 684-8118
(601) 249-0846
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
10291
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00124918
—
MS
05
—
00880090
—
MS
01
—
180000265
PTAN
MS
Enumeration date
07/07/2005
Last updated
04/05/2016
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