Organization
STEPHEN KENNEDY DO LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN D KENNEDY D.O. (PRESIDENT)
(574) 255-4733
Entity
Organization
Contact information
Practice address
1415 LINCOLN WAY W, SUITE O, OSCEOLA, IN 46561-2062
(574) 674-6499
(574) 674-6490
Mailing address
1415 LINCOLN WAY W, SUITE O, OSCEOLA, IN 46561-2062
(574) 674-6499
(574) 674-6490
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
02001650A
IN
Other
Enumeration date
10/04/2007
Last updated
04/10/2008
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