Basic Information
| Provider Information | |||||||||
| NPI: | 1467740662 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | KENT | ||||||||
| FirstName: | HUGH | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1600 WEEOT WAY | ||||||||
| Address2: | |||||||||
| City: | ARCATA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955214734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7078255000 | ||||||||
| FaxNumber: | 7078256747 | ||||||||
| Practice Location | |||||||||
| Address1: | 1600 WEEOT WAY | ||||||||
| Address2: | |||||||||
| City: | ARCATA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955214734 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7078255000 | ||||||||
| FaxNumber: | 7078256747 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/21/2011 | ||||||||
| LastUpdateDate: | 03/06/2015 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | ML60229055 | WA | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | A134487 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.