KENNETH BRYAN GAUTIER (NPI# 1467551465) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1467551465 |
Entity Type | Individual |
Full Name | KENNETH BRYAN GAUTIER |
Credential | M.D. |
Practice Address |
103 Halls Cv Senatobia MS 38668-6620 |
Practice Telephone | 6625629003 |
Mailing Telephone | 6625629003 |
Enumeration Date | 2006-09-22 |
Last Update Date | 2012-02-29 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 2080S0010X |
Pediatrics Specialization: Sports Medicine |
18615 | MS | Allopathic & Osteopathic Physicians |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 06727534 | 05 |
Street Address |
103 HALLS CV |
City | SENATOBIA |
State | MS |
Zip Code | 38668-6620 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1558326488 | Satish C Verma | Pediatrics | 103 Halls Cv, Senatobia, MS 38668-6620 | 2006-04-20 |
1437600277 | Jessica Dupree | Nurse Practitioner | 103 Halls Cv, Senatobia, MS 38668-6620 | 2016-10-17 |
1265756951 | All Children's Clinic,pc | Pediatrics | 103 Halls Cv, Senatobia, MS 38668-6620 | 2010-03-24 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992303010 | Northwest Health and Wellness, Inc | Clinic/Center | 215 Northwest Drive, Senatobia, MS 38668 | 2020-10-12 |
1689218307 | Linda Fay Butler | Technician | 341 Springfield Road, Senatobia, MS 38668 | 2019-11-06 |
1992044754 | Lara J Hayes | Counselor | 1471 Highway 51 S, Senatobia, MS 38668 | 2013-02-13 |
1174653737 | William L Alford | Dentist | 26 Westwood Drive, Senatobia, MS 38668 | 2007-03-06 |
1265576995 | Mays Pharmacy | Durable Medical Equipment & Medical Supplies | 4385 Hwy 51 South, Senatobia, MS 38668 | 2007-02-16 |
1902990997 | Purnima R Purohit | Obstetrics & Gynecology | 135 Keating Rd, Senatobia, MS 38668 | 2006-10-03 |
1356457576 | Jason Andre Cooper | Specialist/Technologist | 214 East Main St., Senatobia, MS 38668 | 2006-08-21 |
1306896386 | Martha M Clinton | Nurse Practitioner | 565 N. Robinson Street, Senatobia, MS 38668 | 2006-05-11 |
1215490214 | Janet Giron-legarda | Case Manager/Care Coordinator | 101 Preston Mckay Dr, Senatobia, MS 38668 | 2019-04-08 |
1558692582 | Tate Family Dentistry, L.L.C. | Dentist | 26 Westwood Drive, Senatobia, MS 38668 | 2010-01-14 |
Find all providers in zip 38668 |
Taxonomy Code | 2080S0010X |
Grouping | Allopathic & Osteopathic Physicians |
Classification | Pediatrics |
Specialization | Sports Medicine |
A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also for the prevention of injury and illness. A sports medicine physician must have knowledge and experience in the promotion of wellness and the prevention of injury. Knowledge about special areas of medicine such as exercise physiology, biomechanics, nutrition, psychology, physical rehabilitation, epidemiology, physical evaluation, injuries (treatment and prevention and referral practice) and the role of exercise in promoting a healthy lifestyle are essential to the practice of sports medicine. The sports medicine physician requires special education to provide the knowledge to improve the healthcare of the individual engaged in physical exercise (sports) whether as an individual or in team participation. |
Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.