Individual
DEREK KENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2775 CHANNING WAY, IDAHO FALLS, ID 83404-7510
(208) 524-0133
Mailing address
2775 CHANNING WAY, IDAHO FALLS, ID 83404-7510
(208) 524-0133
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M-17312
ID
Other
Enumeration date
03/24/2021
Last updated
07/02/2024
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