Individual
DR. KYLE W KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1102 WEST 32ND STREET, JOPLIN, MO 64804
(417) 347-1111
(417) 347-2149
Mailing address
1102 WEST 32ND STREET, JOPLIN, MO 64804
(417) 347-1111
(417) 347-2149
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2004009698
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204642102
—
MO
05
—
243419306
—
MO
Enumeration date
08/01/2006
Last updated
07/08/2007
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