Individual
MICHAEL L KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3901 RAINBOW BLVD, MS 4070, KANSAS CITY, KS 66160-8500
(913) 588-1944
(913) 588-2496
Mailing address
PO BOX 411851, KANSAS CITY, MO 64141-1851
(913) 588-1944
(913) 588-2496
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04-23761
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080167692
RAILROAD MEDICARE
—
05
—
1001142960C
—
KS
05
—
205009913
—
MO
01
—
28736019
BCBS KANSAS CITY
MO
01
—
394060
FIRSTGUARD
KS
Enumeration date
10/04/2006
Last updated
07/16/2014
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