Individual
JOHN SARGENT KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2665 N DECATUR RD, SUITE 730, DECATUR, GA 30033-6149
(404) 508-4320
(404) 508-4112
Mailing address
2665 N DECATUR RD, SUITE 730, DECATUR, GA 30033-6149
(404) 508-4320
(404) 508-4112
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25193
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00280167C
—
GA
Enumeration date
08/24/2005
Last updated
01/15/2025
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