Individual
DONALD J KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3660 VISTA, ST LOUIS, MO 63110
(314) 577-8648
(314) 771-3816
Mailing address
3691 RUTGER AVE, PROVIDER ENROLLMENT, ST LOUIS, MO 63110
(314) 977-4440
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
R9005
MO
Other
Enumeration date
08/18/2006
Last updated
03/18/2008
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