Provider Demographics
NPI:1649364316
Name:KENT FOOT AND ANKLE CENTER INC
Entity type:Organization
Organization Name:KENT FOOT AND ANKLE CENTER INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:C
Authorized Official - Last Name:BARTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:302-735-9811
Mailing Address - Street 1:200 BANNING STREET
Mailing Address - Street 2:SUITE 360
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904
Mailing Address - Country:US
Mailing Address - Phone:302-735-9811
Mailing Address - Fax:302-735-9812
Practice Address - Street 1:200 BANNING STREET
Practice Address - Street 2:SUITE 360
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904
Practice Address - Country:US
Practice Address - Phone:302-735-9811
Practice Address - Fax:302-735-9812
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2011-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEE1-0000125213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000802617Medicaid
DE1000033892Medicaid
G01693OtherMEDICARE PTAN
DE4754580001Medicare NSC