DR. Kenneth Theriot, M.D.

NPI #1114177664 in Mesa, Arizona

Provider Information

NPI Number: 1114177664
Entity Type: Individual
Name: DR. Kenneth Theriot, M.D.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Anesthesiology
Credential: M.D.
Enumeration Date: Sep 21, 2008
Last Updated: Mar 29, 2012

Practice Location

Address: 4002 E MAIN ST STE 1
City: Mesa
State: Arizona
ZIP Code: 85205-8612
Phone: (480) 324-5421

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Anesthesiology	207L00000X	Primary

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