Kenneth Bryan Gautier in Senatobia - Sports Medicine
Kenneth Bryan Gautier - NPI 1467551465
Kenneth Bryan Gautier is a Sports Medicine in Senatobia, Mississippi. Kenneth Bryan Gautier practices all healthcare services and medical treatments related to Sports Medicine. The NPI Number for Kenneth Bryan Gautier is 1467551465. The last update date is 2012-02-29.
Kenneth Bryan Gautier's current location address is 103 Halls Cv, Senatobia, Mississippi. You can contact this provider via phone number 6625629003. The mailing address for Kenneth Bryan Gautier is 103 Halls Cv, Senatobia, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kenneth Bryan Gautier |
|---|---|
| Address | 103 Halls Cv, Senatobia, Mississippi |
| Phone Number | 6625629003 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1467551465 |
|---|---|
| Provider Enumeration Date | 2006-09-22 |
| Last Updated Date | 2012-02-29 |
Provider Mailing Address Detail
| Address | 103 Halls Cv |
|---|---|
| City | Senatobia |
| State | Mississippi (MS) |
| Post Code | 386686620 |
| Phone Number | 6625629003 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Sports Medicine |
|---|---|
| Taxonomy | 2080S0010X |
| Licence No | 18615 |
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Definition: A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experien |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 6727534 | MS | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Kenneth Bryan Gautier by the Centers for Medicare & Medicaid Services?
The Kenneth Bryan Gautier has been assigned the NPI (National Provider Identifier) 1467551465 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete address where Kenneth Bryan Gautier is physically located?
The Kenneth Bryan Gautier is situated at the following address: 103 Halls Cv, Senatobia, MS 386686620.
What is the area of specialization for Kenneth Bryan Gautier, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Kenneth Bryan Gautier is Sports Medicine, and the corresponding taxonomy code that categorizes this area of expertise is 2080S0010X.
On what date did Kenneth Bryan Gautier receive its 1467551465 assignment from the Centers for Medicare & Medicaid Services?
The Kenneth Bryan Gautier was assigned its 1467551465 on 2006-09-22, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
When was the Kenneth Bryan Gautier's information last updated?
The Kenneth Bryan Gautier's information was last updated on 2012-02-29.
NPI Number: 1073517686
Address: 2100 Martin Luther King Jr Blvd, Clovis, NM