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General NPI Number Information
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NPI Number | 1477083301
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Entity Type | Individual
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Provider Name | COLLIN LYLE KENT MD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2017
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Last Update Date | 05/09/2025
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Provider Practice Location Address
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Address Line | 1701 THOMSON DR
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City | LYNCHBURG
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State | VA
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Zip | 24501-1118
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Country | US
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Telephone | 918-607-9063
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Fax |
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Provider Business Mailing Address
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Address Line | 407 SKYLINE AVE
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City | DANVILLE
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State | VA
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Zip | 24540-1925
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 0101275245
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 2022-01555
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License Number State | NC
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