MEDICARE: BRIAN KENT MD INC PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208200000X	Plastic Surgery Physician	28104	OK

General Provider Information

NPI Number	:	1043613300
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRIAN KENT MD INC PC

Provider Business Mailing Address
First Line	:	PO BOX 25277
Second Line	:
City	:	OVERLAND PARK
State	:	KS
Zip	:	66225-5277
Country	:	US
Telephone Number	:	918-994-4100
Fax Number	:	918-994-4103

Provider Business Practice Location Address
First Line	:	9206 S TOLEDO AVE
Second Line	:	SUITE 150
City	:	TULSA
State	:	OK
Zip	:	74137-2754
Country	:	US
Telephone Number	:	918-994-4100
Fax Number	:	918-994-4103

Authorized Official
Title or Position	:	PHYSICIAN/OWNER
Name	:	BRIAN D KENT
Credential	:	M.D.
Telephone Number	:	918-994-4100

Provider Enumeration Date	:	10/01/2014
Last Update Date	:	10/01/2014

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