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Individual

DR. KENYETTA D BRUMMITT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
401 SOUTHCREST CIR STE 104, SOUTHAVEN, MS 38671-6712
(662) 349-1112
(662) 772-2688
Mailing address
965 RIDGE LAKE BLVD STE 315, MEMPHIS, TN 38120-9401
(901) 227-8591

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
055106
GA
207V00000X
Obstetrics & Gynecology Physician
Primary
22216
MS
207V00000X
Obstetrics & Gynecology Physician
E-14934
AR

Other

Enumeration date
06/19/2006
Last updated
12/29/2021
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