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Individual

VINCENT CARL KENT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
107 W PLEASANT AVE, COVINGTON, TN 38019-2535
(901) 475-9229
(901) 475-2828
Mailing address
107 W PLEASANT AVE, COVINGTON, TN 38019-2535
(901) 475-9229
(901) 475-2828

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
027521
TN
207X00000X
Orthopaedic Surgery Physician
27521
TN
207X00000X
Orthopaedic Surgery Physician
G15295
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1513566
TN
05
1821085770
MO
05
3097454
TN
01
4232110
BCBS
TN
01
4356224
BLUE CROSS BLUE SHIELD
TN
Enumeration date
10/04/2005
Last updated
05/20/2014
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