Healthcare Provider Details

I. General information

NPI: 1932223674
Provider Name (Legal Business Name): ALDEN R. KENT P.A.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1ST LEE ST
CHARLOTTESVILLE VA
22908-0001
US

IV. Provider business mailing address

500 RAY C HUNT DR
CHARLOTTESVILLE VA
22903-2981
US

V. Phone/Fax

Practice location:
  • Phone: 434-243-5676
  • Fax: 434-243-5689
Mailing address:
  • Phone: 434-980-6140
  • Fax: 434-972-4266

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0110002000
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: