Provider Demographics
NPI:1770529539
Name:KENT, ALEXANDER R (MD)
Entity type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:R
Last Name:KENT
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Gender:M
Credentials:MD
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Mailing Address - Street 1:125 DOUGHTY ST
Mailing Address - Street 2:STE 330
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-5736
Mailing Address - Country:US
Mailing Address - Phone:843-722-7705
Mailing Address - Fax:843-722-7149
Practice Address - Street 1:125 DOUGHTY ST
Practice Address - Street 2:STE 330
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5736
Practice Address - Country:US
Practice Address - Phone:843-722-7705
Practice Address - Fax:843-722-7149
Is Sole Proprietor?:No
Enumeration Date:2006-06-21
Last Update Date:2008-05-12
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Provider Licenses
StateLicense IDTaxonomies
SC17511207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC175116Medicaid
SCF18021Medicare UPIN