Individual
DR. KAITLYN KENNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4921 PARKVIEW PL, DIV SURG ONCOLOGY, STE 5F, SAINT LOUIS, MO 63110-1032
(314) 362-2280
(888) 352-8360
Mailing address
660 S EUCLID AVE, MSC 8109-0037-09, SAINT LOUIS, MO 63110-1010
(314) 362-2280
(888) 352-8360
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
2022029282
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200112299
—
MO
Enumeration date
04/05/2016
Last updated
10/07/2022
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