DR. KENTRELL MARIE LIDDELL M.D.
NPI 1659384063
Family Medicine in Jackson, MS

Q: What is Kentrell Liddell's NPI number?

The NPI number for Kentrell Liddell is 1659384063. It was assigned to this individual provider in the NPPES registry on August 15, 2006.

Q: What is Kentrell Liddell's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Kentrell Liddell was last updated on April 9, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since August 15, 2006

2104 THOUSAND OAKS DR, JACKSON, MS 39212(601) 346-7450(601) 346-7451 Get Directions Write a Review

NPPES record last updated: April 9, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Dr. Kentrell Marie Liddell M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENTRELL MARIE LIDDELL M.D. (NPI 1659384063) is an individual family medicine provider in Jackson, Mississippi, licensed in Mississippi (17997) and active in the NPI registry since August 2006.

NPPES Registry Identity

NPI1659384063

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. KENTRELL MARIE LIDDELLCredential: M.D.

Location Address2104 THOUSAND OAKS DRJackson, MS 39212-2048

Mailing Address2104 Thousand Oaks DrJackson, MS 39212-2048 · (601) 346-7450 · Fax (601) 346-7451

Phone(601) 346-7450

Fax(601) 346-7451

Sole ProprietorYes

Enumeration DateAugust 15, 2006

Last NPPES UpdateApril 9, 2013

✔ NPI 1659384063 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in MS · 17997

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

2104 THOUSAND OAKS DR, Jackson, MS 39212

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Other Identifiers 5

Other11859914MS · United Healthcare

Medicare PIN080004304MS

Medicaid08072071MS

Other$$$$$$$$$AMS · Blue Cross Blue Shield Of Ms

Medicare UPINI62916MS

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kentrell Liddell's NPI number?

The NPI number for Kentrell Liddell is 1659384063. It was assigned to this individual provider in the NPPES registry on August 15, 2006.

Where is Kentrell Liddell located?

Kentrell Liddell practices at 2104 Thousand Oaks Dr, Jackson, MS 39212. The listed phone number is (601) 346-7450.

What is Kentrell Liddell's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Kentrell Liddell was last updated on April 9, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.