Organization
TIMOTHY C KENNEDY MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TIMOTHY C KENNEDY MD. (PRESIDENT)
(720) 244-6340
Entity
Organization
Contact information
Practice address
2045 ASH ST, DENVER, CO 80207-3717
(720) 244-6340
(303) 321-7033
Mailing address
2045 ASH ST, DENVER, CO 80207-3717
(720) 244-6340
(303) 321-7033
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
18011
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18011
COLORADO MEDICAL LICENSE
CO
Enumeration date
09/19/2012
Last updated
09/19/2012
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