Provider Demographics
NPI:1043261530
Name:DAVID, ALAN KENT (MD)
Entity Type:Individual
Prefix:DR
First Name:ALAN
Middle Name:KENT
Last Name:DAVID
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7450 HOSPITAL DR STE 4500
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43016-9693
Mailing Address - Country:US
Mailing Address - Phone:614-788-0588
Mailing Address - Fax:614-788-0587
Practice Address - Street 1:7450 HOSPITAL DR STE 4500
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9693
Practice Address - Country:US
Practice Address - Phone:614-788-0588
Practice Address - Fax:614-788-0587
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI40446207Q00000X
OH35.063029207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0007802Medicaid
WI1043261530Medicaid
002000328IOtherHUMANA
WI1043261530Medicaid