Provider Demographics
NPI:1649268970
Name:VAWTER, KENNETH WAYNE (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:WAYNE
Last Name:VAWTER
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4881 SUGAR MAPLE DR
Mailing Address - Street 2:WRIGHT-PATTERSON MEDICAL CENTER
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45433
Mailing Address - Country:US
Mailing Address - Phone:937-257-9416
Mailing Address - Fax:919-722-1952
Practice Address - Street 1:4881 SUGAR MAPLE DR
Practice Address - Street 2:WRIGHT PATTERSON AFB
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45433-5529
Practice Address - Country:US
Practice Address - Phone:937-257-9416
Practice Address - Fax:937-656-1235
Is Sole Proprietor?:No
Enumeration Date:2005-10-11
Last Update Date:2015-03-16
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Provider Licenses
StateLicense IDTaxonomies
NC200501605207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery