Individual
JED KINNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1430 TULANE AVE, SL-37, NEW ORLEANS, LA 70112-2632
(504) 988-5458
(504) 988-6808
Mailing address
PO BOX 251418, LITTLE ROCK, AR 72225-1418
(501) 364-1100
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
E-14818
AR
207LP3000X
Pediatric Anesthesiology Physician
E-14818
AR
Other
Enumeration date
04/14/2010
Last updated
01/06/2022
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