Individual
MERLE L KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
560 N CLEVELAND AVE, WESTERVILLE, OH 43082-9105
(614) 839-2300
(614) 839-2301
Mailing address
560 N CLEVELAND AVE, WESTERVILLE, OH 43082-9105
(614) 839-2300
(614) 839-2301
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
35047762K
OH
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
35047762K
OH
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
35047762K
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000120033
ANTHEM PIN
OH
01
—
09-00371
UHC PIN
OH
01
—
1376868448
MEDICARE DME
OH
01
—
1881292-002
CIGNA PIN
OH
01
—
4066846
AETNA PIN
OH
05
—
854875
—
OH
01
—
KE0731251
RAILROAD MEDICARE
OH
Enumeration date
04/07/2006
Last updated
05/13/2013
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