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Individual

KENNETH BRENT KUMMERFELD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
703 S FLEISHEL AVE STE 4000, TYLER, TX 75701-2015
(903) 606-7525
Mailing address
PO BOX 846098, DALLAS, TX 75284-6098
(903) 324-6450

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
F4185
TX
207RI0011X
Interventional Cardiology Physician
Primary
F4185
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
033371305
UNITED HEALTHCARE
TX
05
123074004
TX
01
4416261
AETNA
TX
01
752616977007
TRICARE
TX
01
89425J
BCBS
TX
Enumeration date
09/13/2005
Last updated
07/18/2023
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