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Individual

WILLIAM KENT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
215 MIMS RD, SYLVANIA, GA 30467-1994
(904) 805-1300
(904) 805-1302
Mailing address
PO BOX 532768, ATLANTA, GA 30353-2768
(904) 805-1300
(904) 805-1302

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
9535
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
029035
BLUE CROSS
GA
01
P00238322
RAILROAD MEDICARE
GA
Enumeration date
07/02/2006
Last updated
03/17/2008
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