Individual
CHRIS N KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
597 LIBERTY ST, WEST MILFORD, WV 26451-6801
(304) 745-4568
(304) 326-3700
Mailing address
597 LIBERTY ST, WEST MILFORD, WV 26451-6801
(304) 745-4568
(304) 326-3700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2274
WV
208D00000X
General Practice Physician
2272
WV
208VP0000X
Pain Medicine Physician
Primary
2272
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2272
WV LICENSE 2272
WV
05
—
3810015306
—
WV
Enumeration date
01/22/2008
Last updated
08/24/2022
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