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Individual

JOHN DANIEL KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1650 COUNTY SERVICES PKWY SW, MARIETTA, GA 30008-4010
(770) 514-2300
Mailing address
1650 COUNTY SERVICES PKWY SW, MARIETTA, GA 30008-4010
(770) 514-2300

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
022573
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PENDING
GA
Enumeration date
06/04/2007
Last updated
07/15/2008
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