Individual
KENNETH T BEDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1220 TROTWOOD AVE, SUITE 401, COLUMBIA, TN 38401-6433
(931) 388-6550
(931) 388-6459
Mailing address
854 W JAMES CAMPBELL BLVD, SUITE 303A, COLUMBIA, TN 38401-4659
(931) 540-4255
(931) 490-4654
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
649
TN
Other
Enumeration date
03/27/2009
Last updated
03/27/2009
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