Individual
JAMES M. KENNEDY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25 NORTHRIDGE LN, LEXINGTON, VA 24450-3399
(540) 464-8700
Mailing address
PO BOX 660599, DALLAS, TX 75266-0599
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
L5008
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161229301
—
TX
05
—
161229302
—
TX
05
—
161229303
—
TX
05
—
161229304
—
TX
05
—
161229305
—
TX
05
—
161229307
—
TX
05
—
161229308
—
TX
05
—
161229309
—
TX
05
—
161229310
—
TX
05
—
161229311
—
TX
05
—
161229312
—
TX
01
—
8U7228
BLUE CROSS BLUE SHIELD
TX
Enumeration date
11/30/2005
Last updated
04/26/2018
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