KENNETH M SAMPLE

CAMP LEJEUNE, NC
NPI1205800596
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy208600000X Surgery
(Licence: KY  24465)
Additional Taxonomies208600000X Surgery
(Licence: IN  01053054a)
208600000X Surgery
(Licence: VA  0101253264)
Enumeration Date2006-02-14
Last Update Date2020-02-12
Business Address
Dr. KENNETH M SAMPLE M.D.
100 BREWSTER BLVD
CAMP LEJEUNE, NC 28547-2575
Phone number: 910-450-4760
Mailing Address
Dr. KENNETH M SAMPLE M.D.
897 LYNCHBURG DR
JACKSONVILLE, NC 28546-6018
Phone number: 910-381-6942