MEDICARE: DR. GARRETT COLTON KENT M.D.

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	207Q00000X	Family Medicine Physician	MD81793	SC

General Provider Information

NPI Number	:	1073962759
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARRETT COLTON KENT M.D.

Provider Business Mailing Address
First Line	:	PO BOX 603898
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28260-3898
Country	:	US
Telephone Number	:	843-792-6200
Fax Number	:

Provider Business Practice Location Address
First Line	:	308 CHESTER AVE
Second Line	:
City	:	GREAT FALLS
State	:	SC
Zip	:	29055-1104
Country	:	US
Telephone Number	:	803-482-2129
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2016
Last Update Date	:	08/02/2019

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