NPI 1023265956

Kenneth John Detrick, MD

Practitioner Psychiatry Physician Winston Salem, NC

Practice location

Address: 190 Kimel Park Dr, Winston Salem, NC 27103-6946
Phone: (336) 768-3296
Mailing address: 159 Keswick Dr, Advance, NC 27006-7271

Registered specialties

Psychiatry Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 2084P0800X Licence 9500884 (NC)

Other Psychiatry & Neurology providers in North Carolina →

Registry record

NPI: 1023265956
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Aug 2008
Record last updated: 21 Aug 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.