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Individual

DR. BEN EARL KITCHENS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
302 KAKI ST, IUKA, MS 38852
(662) 423-3662
(662) 423-2509
Mailing address
302 KAKI ST, IUKA, MS 38852
(662) 423-3662
(662) 423-2509

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
00007236
AL
207Q00000X
Family Medicine Physician
Primary
06296
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00123644
MS
01
1558533158
GROUP NPI
MS
Enumeration date
02/07/2006
Last updated
01/19/2010
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