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Individual

KENNETH S HELMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
612 S FLEISHEL AVE, TYLER, TX 75701-2012
(903) 531-5560
Mailing address
PO BOX 5500, TYLER, TX 75712-5500
(903) 324-6400

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
L1882
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
148411502
TX
01
8J9558
BCBSTX
TX
01
8R7271
BCBS OF TEXAS
TX
01
TIN PLU 015
TRICARE
TX
Enumeration date
07/04/2006
Last updated
02/09/2022
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