Backstrand, Kenneth Wilson
Backstrand, Kenneth Wilson is an sole proprietor health care provider with primary practice located at 2721 Del Prado Blvd S , Cape Coral FL 33904-5781. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Anesthesiology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Backstrand, Kenneth Wilson can be contacted via phone (239) 242-8010.Contact Information
Primary practice address
2721 Del Prado Blvd S
Cape Coral FL 33904-5781
Phone: (239) 242-8010
Fax: (239) 242-8020
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | ME0050622 | Florida |
| Allopathic & Osteopathic Physicians / Pain Medicine | 207LP2900X | ME50622 | Florida |
Profile Details
| NPI number | 1114915477 |
|---|---|
| LBN Legal business name | Backstrand, Kenneth Wilson |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 11th, 2005 |
| Last updated | Mar 8th, 2018 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114915477 | NPPES |
| Florida | MEDICAID | 046206300 |
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