Healthcare Provider Details

I. General information

NPI: 1194718718
Provider Name (Legal Business Name): ALANA MARIA KENT MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 08/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14244 HIGHWAY 515 N SUITE 100
ELLIJAY GA
30536
US

IV. Provider business mailing address

14244 HIGHWAY 515 N SUITE 100
ELLIJAY GA
30536
US

V. Phone/Fax

Practice location:
  • Phone: 706-698-5433
  • Fax: 706-698-5445
Mailing address:
  • Phone: 706-698-5433
  • Fax: 706-698-5445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number051241
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: