Provider Demographics
NPI:1346284296
Name:KENT, LAWRENCE TAMBLING (MD)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:TAMBLING
Last Name:KENT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1611 S GREEN RD
Mailing Address - Street 2:SUITE 260
Mailing Address - City:SOUTH EUCLID
Mailing Address - State:OH
Mailing Address - Zip Code:44121-4128
Mailing Address - Country:US
Mailing Address - Phone:216-381-6177
Mailing Address - Fax:216-297-2117
Practice Address - Street 1:1611 S GREEN RD
Practice Address - Street 2:SUITE 260
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-4128
Practice Address - Country:US
Practice Address - Phone:216-381-6177
Practice Address - Fax:216-297-2117
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-1629207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0463051Medicare ID - Type Unspecified
OHA78699Medicare UPIN