Individual
DR. JOSEPH A. KWENTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3531 LAKELAND DRIVE, SUITE 1060 BRENTWOOD PLAZA, FLOWOOD, MS 39232
(601) 420-5810
(601) 420-5811
Mailing address
P.O. BOX 321015, FLOWOOD, MS 39232
(601) 420-5810
(601) 420-5811
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
17834
MS
2084F0202X
Forensic Psychiatry Physician
17834
MS
2084N0400X
Neurology Physician
17834
MS
2084P0800X
Psychiatry Physician
Primary
17834
MS
2084P0805X
Geriatric Psychiatry Physician
17834
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00018209
—
MS
05
—
00126737
—
MS
01
—
860000121
PALMETTO GBA-RAILROAD MED
MS
Enumeration date
07/03/2006
Last updated
04/28/2021
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