Healthcare Provider Details

I. General information

NPI: 1114411063
Provider Name (Legal Business Name): KENNETH AARON GARRETT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/14/2018
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W COMMONS BLVD
NEW CASTLE DE
19720-2419
US

IV. Provider business mailing address

100 W COMMONS BLVD STE 400
NEW CASTLE DE
19720-2419
US

V. Phone/Fax

Practice location:
  • Phone: 302-709-4709
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberC2-0024841
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: