Provider Demographics
NPI:1740048545
Name:KENT, TIMOTHY J (PARAMEDIC)
Entity type:Individual
Prefix:MR
First Name:TIMOTHY
Middle Name:J
Last Name:KENT
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 W ALBERTSON DR
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240-1929
Mailing Address - Country:US
Mailing Address - Phone:575-399-6124
Mailing Address - Fax:
Practice Address - Street 1:3324 N LOVINGTON HWY
Practice Address - Street 2:
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240-1087
Practice Address - Country:US
Practice Address - Phone:575-399-6124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-07
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM00014589207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services