IndividualActive
Kenneth Gautier, M.D.
NPI 1467551465 · Pediatric Sports Medicine Physician · Senatobia, MS
Provider details
- NPI number
- 1467551465
- Entity type
- Individual
- Primary specialty
- Pediatric Sports Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- 18615 (MS)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
103 Halls Cv
Senatobia, MS 38668-6620
Phone: (662) 562-9003
Approximate (ZIP-level) locationGet directions
Mailing address
103 Halls Cv
Senatobia, MS 38668-6620
Registry dates
- Enumerated
- 2006-09-22
- Last updated
- 2012-02-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.