Individual
DR. JAMES GRAY KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
78878 US HIGHWAY 40, WINTER PARK, CO 80482-1312
(970) 722-0300
(970) 722-1032
Mailing address
PO BOX 1312, WINTER PARK, CO 80482-1312
(970) 722-0300
(970) 722-1032
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20996
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1209964
—
CO
01
—
20996
LICENSE
CO
Enumeration date
07/08/2005
Last updated
12/01/2011
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