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NPI Code Detail

MEDICARE: DR. DOUGLAS KENT PHD

MEDICARE:  DR. DOUGLAS  KENT  PHD
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
1103TC0700XClinical PsychologistPSY004359GA

General Provider Information

NPI Number : 1811151343
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS KENT PHD
Provider Business Mailing Address
First Line : 1050 CROWN POINTE PKWY STE 500
Second Line :
City : ATLANTA
State : GA
Zip : 30338-7702
Country : US
Telephone Number : 404-940-8080
Fax Number :
Provider Business Practice Location Address
First Line : 1050 CROWN POINTE PKWY STE 500
Second Line :
City : ATLANTA
State : GA
Zip : 30338-7702
Country : US
Telephone Number : 404-940-8080
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2008
Last Update Date : 01/08/2020

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Directions to “ DR. DOUGLAS KENT PHD” Practice Location

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