Provider Demographics
NPI:1003016106
Name:KENNETH K. VEST,M.D.P.A.
Entity Type:Organization
Organization Name:KENNETH K. VEST,M.D.P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:K
Authorized Official - Last Name:VEST
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-525-5604
Mailing Address - Street 1:P.O BOX 20407
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71903-0407
Mailing Address - Country:US
Mailing Address - Phone:501-525-5604
Mailing Address - Fax:501-525-5604
Practice Address - Street 1:190 VEST LN
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-7827
Practice Address - Country:US
Practice Address - Phone:501-525-5604
Practice Address - Fax:501-525-5604
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-18
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC71602084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR51227B484Medicare Oscar/Certification
AR5B484Medicare PIN