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Kenneth Albert Terhaar

Radiology

Allopathic & Osteopathic Physicians

3599 University Blvd S, Bldg 300, Jacksonville, FL 32216

PECOS Enrollment

This provider is enrolled in PECOS as KENNETH TERHAAR.

Based on the most recent information from CMS, provider Kenneth Albert Terhaar is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:51 AM.

Profile Details

Provider ID
1245225317
Provider Type
Individual
Full Name
Terhaar, Kenneth Albert
Credential
M.D.

Gender
Male
Sole Proprietor
No
Enumeration Date
9/15/2005
Last Updated
2/27/2019

Contact Information

Practice Location

3599 University Blvd S, Bldg 300, Jacksonville, FL 32216

(904) 399-5550

(904) 346-4334

Mailing Location

2080 Child St, Jacksonville, FL 32214

(904) 542-7363

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 2085R0202X Primary	Description Radiology Allopathic & Osteopathic Physicians	License 0101233211 Virginia

Kenneth Albert Terhaar

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Gordon, Patrick O

Mazzella, John Louis

Rmed Llc

Medical Diagnostic Center Of Jacksonville

Tuttle, Mitch

Aquino-Aponte, Carlos F

Wulfeck, Dennis W

Global Diagnostic Imaging Centers

Vega, George L.

Bogineni-Misra, Sudha