Individual
ROD G KRENTEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1340 BROAD AVE STE 140, GULFPORT, MS 39501
(228) 575-2950
Mailing address
1340 BROAD AVE STE 140, GULFPORT, MS 39501-2445
(228) 575-2950
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
00019798
AL
2085R0001X
Radiation Oncology Physician
Primary
16116
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000033662
—
AL
Enumeration date
08/22/2005
Last updated
09/05/2018
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