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NPI Code Detail

MEDICARE: DR. EDWARD F. KENT JR. MD

MEDICARE:  DR. EDWARD F. KENT JR. MD
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
1207K00000XAllergy & Immunology PhysicianVT

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
230F541OTHERNYBCBS NORTHEAST NY
33V002OTHERVTMVP
40055573-001OTHERVTCIGNA
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
69969OTHERVTBLUE CROSS BLUE SHIELD VT

General Provider Information

NPI Number : 1124023577
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EDWARD F. KENT JR. MD
Provider Business Mailing Address
First Line : 53 TIMBER LN
Second Line :
City : SOUTH BURLINGTON
State : VT
Zip : 05403-5201
Country : US
Telephone Number : 802-864-0294
Fax Number : 802-864-3779
Provider Business Practice Location Address
First Line : 53 TIMBER LN
Second Line :
City : SOUTH BURLINGTON
State : VT
Zip : 05403-5201
Country : US
Telephone Number : 802-864-0294
Fax Number : 802-864-3779
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/14/2005
Last Update Date : 07/09/2007

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Directions to “ DR. EDWARD F. KENT JR. MD” Practice Location

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