Provider Demographics
NPI:1104189612
Name:KENT, ANNA R (DO)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:R
Last Name:KENT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3421 CONCORD RD
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-9001
Mailing Address - Country:US
Mailing Address - Phone:717-466-2426
Mailing Address - Fax:717-270-3759
Practice Address - Street 1:446 N READING RD
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:PA
Practice Address - Zip Code:17522-9802
Practice Address - Country:US
Practice Address - Phone:717-466-2426
Practice Address - Fax:717-270-3759
Is Sole Proprietor?:No
Enumeration Date:2012-06-19
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS016871207Q00000X, 207QH0002X
PAFK4526717207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1831119221OtherGROUP NPI
PA867633OtherMEDICARE GROUP #
PA103130638Medicaid
PA1007307260059OtherMEDICAID GROUP #