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Individual

PHILIP KENNEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4301 W MARKHAM ST # 556, LITTLE ROCK, AR 72205-7101
(501) 686-8000
Mailing address
4301 W MARKHAM ST # 556, LITTLE ROCK, AR 72205-7101
(501) 686-8000

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
12521
AL
2085R0202X
Diagnostic Radiology Physician
Primary
E-5653
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000015482
BLUE CROSS
AL
05
000015482
AL
01
00117079
MISSISSIPPI MEDICAID
MS
05
009909405
AL
05
009937203
AL
01
010033CC76169
SECTION 1011
AL
01
051505919
BLUE CROSS
AL
05
051505919
AL
01
051511500
BLUE CROSS
AL
01
051512215
BLUE CROSS
AL
01
051534428
BLUE CROSS
AL
05
169640001
AR
01
300059301
RAILROAD MEDICARE
AL
01
C76169
VIVA
AL
Enumeration date
06/28/2006
Last updated
10/13/2008
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