Provider Demographics
NPI:1013442458
Name:KENT, LAURA MARIE (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:MARIE
Last Name:KENT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-695-6697
Mailing Address - Fax:
Practice Address - Street 1:48 CENTENNIAL WAY
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29605-4662
Practice Address - Country:US
Practice Address - Phone:864-522-8000
Practice Address - Fax:864-522-8005
Is Sole Proprietor?:No
Enumeration Date:2017-04-24
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
SC92843207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program