Provider Demographics
NPI:1508821695
Name:ROLLINS, KENT L (MD)
Entity Type:Individual
Prefix:DR
First Name:KENT
Middle Name:L
Last Name:ROLLINS
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 1:9101 STONY POINT DR
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23235
Mailing Address - Country:US
Mailing Address - Phone:804-330-9105
Mailing Address - Fax:804-287-6119
Practice Address - Street 1:9101 STONY POINT DR
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23235
Practice Address - Country:US
Practice Address - Phone:804-330-9105
Practice Address - Fax:804-287-6119
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101 036102208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA213OtherCARENET
VA2846OtherCIGNA
VACL9160OtherRAILROAD MEDICARE GROUP #
VA59308OtherSOUTHERN HEALTH
VA005666643Medicaid
VA642075000-00OtherQUALCHOICE
VA4063695OtherAETNA PPO
VA1900463OtherUNITED HEALTHCARE
VA45733OtherSENTARA FAMILY CARE
VA790542OtherAETNA HMO
VAC01241OtherMEDICARE GROUP #
VA230761751OtherTRICARE
VA24384OtherALLIANCE
VA340003852OtherRAILROAD MEDICARE
VA005666643Medicaid