Healthcare Provider Details

I. General information

NPI: 1184243230
Provider Name (Legal Business Name): RYAN EARLE KENT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2020
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2810 N PARHAM RD STE 315
RICHMOND VA
23294-4424
US

IV. Provider business mailing address

PO BOX 117653
ATLANTA GA
30368-7653
US

V. Phone/Fax

Practice location:
  • Phone: 804-288-8327
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA194604
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101289135
License Number StateVA
# 3
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number0101289135
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: