Provider Demographics
NPI:1043613300
Name:BRIAN KENT MD INC PC
Entity Type:Organization
Organization Name:BRIAN KENT MD INC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:D
Authorized Official - Last Name:KENT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:918-994-4100
Mailing Address - Street 1:PO BOX 25277
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66225-5277
Mailing Address - Country:US
Mailing Address - Phone:918-994-4100
Mailing Address - Fax:918-994-4103
Practice Address - Street 1:9206 S TOLEDO AVE
Practice Address - Street 2:SUITE 150
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74137-2754
Practice Address - Country:US
Practice Address - Phone:918-994-4100
Practice Address - Fax:918-994-4103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-01
Last Update Date:2014-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK28104208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty