Backstrand, Kenneth Wilson

Backstrand, Kenneth Wilson is an sole proprietor health care provider with primary practice located at 2721 Del Prado Blvd S , Cape Coral FL 33904-5781. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Backstrand, Kenneth Wilson can be contacted via phone (239) 242-8010.

Contact Information

Primary practice address
2721 Del Prado Blvd S Cape Coral FL 33904-5781
Phone: (239) 242-8010
Fax: (239) 242-8020
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X ME0050622 Florida
Allopathic & Osteopathic Physicians / Pain Medicine 207LP2900X ME50622 Florida

Profile Details

NPI number 1114915477
LBN Legal business name Backstrand, Kenneth Wilson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 11th, 2005
Last updated Mar 8th, 2018 - about 6 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 1114915477 NPPES
Florida MEDICAID 046206300

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