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Individual

KENT REYNOLDS BURRESS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
1819 WASHINGTON AVE, EVANSVILLE, IN 47714
(812) 457-7020
(812) 477-0200
Mailing address
1819 WASHINGTON AVE, EVANSVILLE, IN 47714
(812) 477-0200
(812) 477-1267

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
0700515
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100246800A
IN
Enumeration date
11/15/2005
Last updated
02/07/2008
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