Individual
JUSTIN C KENNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9430 PARK WEST BLVD STE 130, KNOXVILLE, TN 37923-4205
(865) 690-4861
(865) 560-8525
Mailing address
PO BOX 306556, NASHVILLE, TN 37230-6556
(865) 694-0062
(865) 694-7907
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
58814
TN
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
58814
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q047643
—
TN
Enumeration date
06/24/2013
Last updated
07/11/2025
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