Doctor Name: | DR. JOSEPH A. KWENTUS |
NPI Number: | 1477582096 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 17834 |
Business Practice Address: | 3531 Lakeland Drive Suite 1060 Brentwood Plaza Flowood, MS - 39232 |
Business Phone Number: | 6014205810 |
Business Fax Number: | 6014205811 |
Mailing Address: | P.o. Box 321015, FLOWOOD |
State: | MS |
Postal Code: | 39232 |
Phone Number: | 6014205810 |
Fax Number: | 6014205811 |
NPI Enumeration Date: | 07/03/2006 |
NPI Last Update Date: | 08/08/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 17834 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | MS |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |