Individual
JOSEPH KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2815 EDGEWOOD RD SW, CEDAR RAPIDS, IA 52404-3258
(319) 396-9097
(319) 396-8284
Mailing address
PO BOX 786, CEDAR RAPIDS, IA 52406-0786
(319) 369-4505
(319) 369-4677
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2750
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0222646
—
IA
Enumeration date
03/29/2006
Last updated
10/30/2007
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