Individual
DR. KENT THOMAS ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2503 FOREST HILLS RD W STE B, WILSON, NC 27893-3392
(252) 991-0555
(252) 991-0596
Mailing address
PO BOX 3775, WILSON, NC 27895-3775
(252) 291-1928
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
27354
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11516
BC
NC
05
—
8911516
—
NC
05
—
891154R
—
NC
01
—
P00165585
RRMC
—
Enumeration date
06/22/2005
Last updated
06/26/2015
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