Provider Demographics
NPI:1255549374
Name:KO, KENTON (MD)
Entity type:Individual
Prefix:
First Name:KENTON
Middle Name:
Last Name:KO
Suffix:
Gender:
Credentials:MD
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Mailing Address - Street 1:1 JARRETT WHITE RD
Mailing Address - Street 2:TAMC, CAFBHS, 2B-300A
Mailing Address - City:TRIPLER ARMY MEDICAL CENTER
Mailing Address - State:HI
Mailing Address - Zip Code:96859-5001
Mailing Address - Country:US
Mailing Address - Phone:808-433-6418
Mailing Address - Fax:808-433-4890
Practice Address - Street 1:1 JARRETT WHITE RD
Practice Address - Street 2:TAMC, CAFBHS, 2B-300A
Practice Address - City:TRIPLER ARMY MEDICAL CENTER
Practice Address - State:HI
Practice Address - Zip Code:96859-5001
Practice Address - Country:US
Practice Address - Phone:808-433-6418
Practice Address - Fax:808-433-4890
Is Sole Proprietor?:No
Enumeration Date:2007-05-21
Last Update Date:2025-04-25
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Provider Licenses
StateLicense IDTaxonomies
HIMD132862084P0800X
HIMD-132862084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry