KENT DOUGLAS ANDRE — OIG Excluded Provider (VERMILLION, SD, 1128b4)
KENT DOUGLAS ANDRE — OIG Excluded Provider (VERMILLION, SD, 1128b4) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: KENT DOUGLAS ANDRE; Type: Individual; Provider category: IND- LIC HC SERV PRO.
| Name | KENT DOUGLAS ANDRE |
|---|---|
| Type | Individual |
| Provider category | IND- LIC HC SERV PRO |
| Specialty | LICENSED PRACTITIONE |
| NPI | 1245425974 |
| City | VERMILLION |
| State | SD |
| ZIP | 57069 |
| Exclusion authority | 1128b4 |
| Exclusion reason | License revocation, suspension, or surrender |
| Exclusion date | 2017-10-19 |
| Source | HHS-OIG LEIE |
$1499/mo
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