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Individual

DR. KENT JACK HOMNICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
42 UNITY PL, PAWLEYS ISLAND, SC 29585-6188
(843) 446-0937
Mailing address
42 UNITY PL, PAWLEYS ISLAND, SC 29585-6188
(843) 446-0937

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD32690
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
323292100
MN
Enumeration date
09/20/2006
Last updated
08/31/2015
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