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STEPHEN KENNEDY DO LLC NPI 1114115045


NPI Information

NPI: 1114115045
Provider Name: STEPHEN KENNEDY DO LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
1415 LINCOLN WAY W
SUITE O
OSCEOLA, IN
ZIP 46561
Phone: (574) 674-6499
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STEPHEN KENNEDY DO LLC is a family medicine in Osceola, IN. The provider is 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. STEPHEN KENNEDY DO LLC NPI is 1114115045. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1415 LINCOLN WAY W
SUITE O
OSCEOLA, IN
ZIP 46561-062
Phone: (574) 674-6499
Fax: (574) 674-6490

The provider's authorized official is Stephen D Kennedy .
The authorized official title is President and has the following contact phone number (574) 255-4733.

The enumeration date for this NPI number is 10/4/2007 and was last updated on 4/10/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine02001650AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1235470MEDICARE PININDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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