Dr. Brenden Kootsey, M.D.
Pediatrics in Kilmarnock, VA. Individual provider (NPI-1).
NPI number1487911095
StatusActive
Last updated in NPPESAug 7, 2018
Details
- NPI
- 1487911095
- Entity type
- Individual (NPI-1)
- Name
- Dr. Brenden Kootsey
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 19, 2012
- Last updated
- Aug 7, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208000000X | Pediatrics | 0101264322 | VA | Yes |
| 208000000X | Pediatrics | 52671 | TN | |
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – |
Practice location
86 Harris RdKilmarnock, VA 22482
Phone 804-435-1152 · Fax 804-434-8080
Mailing address
86 Harris RdKilmarnock, VA 22482-3845
Phone 804-435-1152 · Fax 804-435-8080
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