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NPI Profile for KENNETH T BEDOCK in COLUMBIA, TN.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Surgical |
363AS0400X | 97 | Physician Assistant |
| NPI # | 1780826461 |
|
| Status | Active | |
| Credentials | PA (Physician Assistant) | |
| Entity | Individual | |
| Enumeration date | 03/27/2009 | |
| Last updated | 03/27/2009 - About 17 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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KENNETH T BEDOCK
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KENNETH T BEDOCK, PA