# RICHARD D KENNEDY

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1578689493
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 35.089392 | OH | Yes |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician | 35.089392 | OH | — |

## Other

- **Enumeration date:** 03/22/2007
- **Last updated:** 05/11/2018

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000474321 | OHIO MEDICAID UNISON | OH |
| 01 | — | 2728632 | OH MEDICAID MOLINA | OH |
| 05 | — | 2728632 | — | OH |
| 01 | — | 310917085274 | OH MEDICAID CARESOURCE | OH |
| 05 | — | 3810022215 | — | WV |