# STEPHEN KENNEDY DO LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1114115045
- **Authorized official:** DR. STEPHEN D KENNEDY D.O. (PRESIDENT)
- **Authorized official phone:** (574) 255-4733

## Contact information

- **Practice address:** 1415 LINCOLN WAY W, SUITE O, OSCEOLA, IN 46561-2062
- **Practice address phone:** (574) 674-6499
- **Practice address fax:** (574) 674-6490
- **Mailing address:** 1415 LINCOLN WAY W, SUITE O, OSCEOLA, IN 46561-2062
- **Mailing address phone:** (574) 674-6499
- **Mailing address fax:** (574) 674-6490

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 02001650A | IN | Yes |

## Other

- **Enumeration date:** 10/04/2007
- **Last updated:** 04/10/2008