Avery, Kenneth Burton

Avery, Kenneth Burton is an sole proprietor health care provider with primary practice located at 1600 Medical Center Dr Suite G500, Huntington WV 25701-3656. He recently has only one registered license in Podiatric Medicine & Surgery Service Providers / Podiatrist, which is considered as his primary health care specialty. Avery, Kenneth Burton can be contacted via phone (304) 691-1262.

Contact Information

Primary practice address
1600 Medical Center Dr Suite G500 Huntington WV 25701-3656
Phone: (304) 691-1262
Fax: (304) 691-1666
Website:
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Health care specialties

SpecialtyCodeLicense #State
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 00295 Kentucky
Podiatric Medicine & Surgery Service Providers / Podiatrist 213E00000X 00357 West Virginia

Profile Details

NPI number 1154334696
LBN Legal business name Avery, Kenneth Burton
Credentials Doctor of Podiatric Medicine (DPM)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 15th, 2006
Last updated Nov 17th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1154334696 NPPES
West Virginia MEDICAID 2107501000
West Virginia MEDICAID 80000060

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