Joshua Bradley Kentosh in Peoria - Procedural Dermatology
Joshua Bradley Kentosh - NPI 1902096928
Joshua Bradley Kentosh is a Procedural Dermatology in Peoria, Illinois. Joshua Bradley Kentosh practices all healthcare services and medical treatments related to Procedural Dermatology. The NPI Number for Joshua Bradley Kentosh is 1902096928. The last update date is 2018-07-12.
Joshua Bradley Kentosh's current location address is 4909 N. Glen Park Place, Peoria, Illinois. You can contact this provider via phone number 3096747546 and fax number 3092822075. The mailing address for Joshua Bradley Kentosh is 4909 N. Glen Park Place, Peoria, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Joshua Bradley Kentosh |
|---|---|
| Address | 4909 N. Glen Park Place, Peoria, Illinois |
| Phone Number | 3096747546 |
| Fax Number | 3092822075 |
| Sole Proprietor | Y |
| Credentials | D.O. |
NPI Number Detail
| NPI Number | 1902096928 |
|---|---|
| Provider Enumeration Date | 2007-07-26 |
| Last Updated Date | 2018-07-12 |
Provider Mailing Address Detail
| Address | 4909 N. Glen Park Place |
|---|---|
| City | Peoria |
| State | Illinois (IL) |
| Post Code | 616144676 |
| Phone Number | 3096747546 |
| Fax Number | 3092822075 |
Provider's Primary Taxonomy Detail
| Speciality | Procedural Dermatology |
|---|---|
| Taxonomy | 207Ns0135X |
| Licence No | 36.142442 |
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Definition: Procedural Dermatology, a subspecialty of Dermatology, encompassing a wide variety of surgical procedures and methods to remove or modify skin tissue for health or cosmetic benefit. These methods include scalpel surgery, laser surgery, chemical surge |
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What is the Joshua Bradley Kentosh's unique identification number?
The Joshua Bradley Kentosh has been assigned the NPI (National Provider Identifier) Number 1902096928 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you provide the complete physical address where Joshua Bradley Kentosh is located?
The Joshua Bradley Kentosh is situated at the following address: 4909 N. Glen Park Place, Peoria, IL, 616144676.
What is the Joshua Bradley Kentosh's area of specialization and corresponding taxonomy classification?
The Joshua Bradley Kentosh's specialty field is Procedural Dermatology, and it falls under the taxonomy code 207Ns0135X, which categorizes healthcare providers based on their specialties.
When was the Joshua Bradley Kentosh's 1902096928 issued?
The Joshua Bradley Kentosh's 1902096928 was issued on 2007-07-26.
As of what date were the details pertaining to Joshua Bradley Kentosh last refreshed?
The information related to the Joshua Bradley Kentosh, including its address, specialty, and other relevant details, was last updated on 2018-07-12.
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