Provider Demographics
NPI:1467612085
Name:SCHNETZLER, KENT ALLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:ALLEN
Last Name:SCHNETZLER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:400 CRESTWOOD CIRCLE
Mailing Address - Street 2:SUITE L
Mailing Address - City:MENA
Mailing Address - State:AR
Mailing Address - Zip Code:71953
Mailing Address - Country:US
Mailing Address - Phone:479-394-1414
Mailing Address - Fax:479-394-2612
Practice Address - Street 1:400 CRESTWOOD CIRCLE
Practice Address - Street 2:SUITE L
Practice Address - City:MENA
Practice Address - State:AR
Practice Address - Zip Code:71953
Practice Address - Country:US
Practice Address - Phone:479-394-1414
Practice Address - Fax:479-394-2612
Is Sole Proprietor?:No
Enumeration Date:2008-06-17
Last Update Date:2012-04-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO43811207XX0005X
ARE-5824207XX0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0005XAllopathic & Osteopathic PhysiciansOrthopaedic SurgerySports Medicine