Individual
MR. MICHAEL ARTHUR KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
111 E HWY 120, STE. 104, POTTSBORO, TX 75076-3008
(903) 786-3911
Mailing address
1038 ADDISON AVE, POTTSBORO, TX 75076-7077
(903) 786-8916
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA04828
TX
Other
Enumeration date
12/12/2006
Last updated
02/19/2009
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