Individual
DR. RAY C KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
727 HOSPITAL DR, SHELBYVILLE, KY 40065-1660
(502) 647-4347
Mailing address
PO BOX 8, LOUISVILLE, KY 40201-0008
(800) 476-8646
(919) 382-3210
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
28102
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000060164
BCBS 12 DIGIT ID NUMBER
KY
01
—
000000275811
BCBS 12 DIGIT ID NUMBER
KY
01
—
1069939
PASSPORT GROUP # 1172544
KY
01
—
50000549
PASSPORT GROUP # 50000548
KY
05
—
64281025
—
KY
Enumeration date
06/15/2005
Last updated
07/09/2007
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