# RICHARD T KENNEDY MD LLC

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

## Provider details

- **NPI number:** 1790059939
- **Authorized official:** RICHARD T KENNEDY M.D. (OWNER)
- **Authorized official phone:** (334) 793-6556

## Contact information

- **Practice address:** 2115 W MAIN ST, DOTHAN, AL 36301-1289
- **Practice address phone:** (334) 793-6556
- **Practice address fax:** (334) 793-2583
- **Mailing address:** 2115 W MAIN ST, DOTHAN, AL 36301-1289
- **Mailing address phone:** (334) 793-6556
- **Mailing address fax:** (334) 793-2583

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 8459 | AL | Yes |

## Other

- **Enumeration date:** 03/06/2012
- **Last updated:** 03/06/2012