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Contact Information

KENNETH B GAUTIER, MD
103 HALLS CV
SENATOBIA, MS38668-6620
 Phone: 662-562-9003
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

2080S0010X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for KENNETH B GAUTIER · (Male)

NPI # 1467551465
Status Active
Credentials MD
Entity Individual
Enumeration date 09/22/2006
Last updated 02/29/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • MS License # 18615
  • MS Medicaid 06727534
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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