Individual
ROBERT G KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
724 S MASON ST MSC 7901, HARRISONBURG, VA 22807-5705
(540) 568-5728
Mailing address
724 S MASON ST MSC 7901, HARRISONBURG, VA 22807-5705
(540) 568-5728
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101238231
VA
207Q00000X
Family Medicine Physician
C161212
CA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
0101238231
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010160367
VA PREMIER
VA
05
—
010160367
—
VA
01
—
179367
ANTHEM
VA
01
—
315335
SOUTHERN HEALTH
VA
01
—
5630042
FIRST HEALTH
VA
01
—
97250
OPTIMA
VA
01
—
VVE6439975
MEDICARE PTAN-AHWI
VA
Enumeration date
02/07/2006
Last updated
07/09/2023
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