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General NPI Number Information
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NPI Number | 1376079160
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Entity Type | Organization
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Legal Business Name | RICHARD L KERN JR MD PLLC
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Dates
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Enumeration Date | 05/11/2017
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Last Update Date | 05/11/2017
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Provider Practice Location Address
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Address Line | 1722 9TH ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-5003
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Country | US
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Telephone | 940-322-1075
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Fax | 940-322-1614
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Provider Business Mailing Address
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Address Line | 1722 9TH ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-5003
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Country | US
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Telephone | 940-322-1075
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Fax | 940-322-1614
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Authorized Official
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Title or Position | SOLE MEMBER - OWNER
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Name | RICHARD LEE KERN JR.
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Credential | MD
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Telephone | 423-602-8664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number |
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License Number State |
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