Provider Demographics
NPI:1992386940
Name:VERBOS, KENNETH W II (MD)
Entity type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:W
Last Name:VERBOS
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 W MITCHELL ST STE C70
Mailing Address - Street 2:
Mailing Address - City:PETOSKEY
Mailing Address - State:MI
Mailing Address - Zip Code:49770-2275
Mailing Address - Country:US
Mailing Address - Phone:231-487-7200
Mailing Address - Fax:231-487-7188
Practice Address - Street 1:560 W MITCHELL ST STE C70
Practice Address - Street 2:
Practice Address - City:PETOSKEY
Practice Address - State:MI
Practice Address - Zip Code:49770-2275
Practice Address - Country:US
Practice Address - Phone:231-487-7200
Practice Address - Fax:231-487-7188
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020031547207Q00000X
MI4351049233207Q00000X
MI4301511926207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine