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Individual

DR. JEREMY SCOTT KENNEDY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
611 WATKINS CENTRE PKWY STE 350, MIDLOTHIAN, VA 23114-4404
(804) 464-8644
(804) 464-8508
Mailing address
611 WATKINS CENTRE PKWY STE 350, MIDLOTHIAN, VA 23114-4404
(804) 464-8644
(804) 464-8508

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0102209089
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1528022779
BLUE CROSS BLUE SHIELD
AZ
01
3437670
UNITED HEALTHCARE
AZ
01
4Z8735
HEALTH NET
01
707257
AHCCCS
AZ
05
707257
AZ
01
9558781
AETNA
AZ
01
P01043135
RAILROAD MEDICARE
AZ
Enumeration date
04/14/2006
Last updated
07/23/2025
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