Organization
STEPHEN KENNEDY, MD, INC.
Active
Other names
Elk Grove Bone Densitometry Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN WILLIAM KENNEDY MD (DIRECTOR)
(916) 691-2069
Entity
Organization
Contact information
Practice address
9300 W STOCKTON BLVD, SUITE # 104, ELK GROVE, CA 95758-8070
(916) 691-2069
(916) 691-2065
Mailing address
9300 W STOCKTON BLVD, SUITE # 104, ELK GROVE, CA 95758-8070
(916) 691-2069
(916) 691-2065
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
A 86061
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1689668279
MEDICARE NPI - INDIVIDUAL FOR DR. STEPHEN KENNEDY
—
Enumeration date
08/30/2006
Last updated
11/09/2009
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