Individual
DR. KEVIN P. KENNALLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1115 MAIN, SABETHA, KS 66534
(785) 284-2141
(785) 284-0445
Mailing address
P.O. BOX 229, SABETHA, KS 66534
(785) 284-2141
(785) 284-0445
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
04 - 19100
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100194190C
—
KS
Enumeration date
06/30/2006
Last updated
01/21/2021
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