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General NPI Number Information
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NPI Number | 1992386940
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Entity Type | Individual
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Provider Name | KENNETH W VERBOS II MD
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Gender | Male
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Dates
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Enumeration Date | 04/20/2021
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 560 W MITCHELL ST STE C70
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City | PETOSKEY
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State | MI
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Zip | 49770-2275
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Country | US
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Telephone | 231-487-7200
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Fax | 231-487-7188
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Provider Business Mailing Address
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Address Line | 560 W MITCHELL ST STE C70
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City | PETOSKEY
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State | MI
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Zip | 49770-2275
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Country | US
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Telephone | 231-487-7200
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Fax | 231-487-7188
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 2020031547
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4351049233
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 4301511926
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License Number State | MI
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