MEDICARE: DR. ALANA MARIA KENT MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	051241	GA

General Provider Information

NPI Number	:	1194718718
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALANA MARIA KENT MD

Provider Business Mailing Address
First Line	:	14244 HIGHWAY 515 N
Second Line	:	SUITE 100
City	:	ELLIJAY
State	:	GA
Zip	:	30536
Country	:	US
Telephone Number	:	706-698-5433
Fax Number	:	706-698-5445

Provider Business Practice Location Address
First Line	:	14244 HIGHWAY 515 N
Second Line	:	SUITE 100
City	:	ELLIJAY
State	:	GA
Zip	:	30536
Country	:	US
Telephone Number	:	706-698-5433
Fax Number	:	706-698-5445

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/30/2005
Last Update Date	:	08/06/2014

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