KENNETH JAY IVERSON

NEWPORT, RI
NPI1124065313
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: FL  ME0061931)
Enumeration Date2006-05-31
Last Update Date2007-07-08
Business Address
-- KENNETH JAY IVERSON MD
43 SMITH RD NAVAL HEALTH CARE NEW ENGLAND NEWPORT
NEWPORT, RI 02841-1002
Phone number: 860-694-2377
Mailing Address
-- KENNETH JAY IVERSON MD
RTE 12 BLDG 449 ATTN PROFESSIONAL AFFAIRS NAVAL HEALTH CARE NEW ENGLAND GROTON
GROTON, CT 06349-5600
Phone number: 860-694-2377
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