Individual
JEFFREY JAMES KENYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2112 EAST PARIS AVE SE, GRAND RAPIDS, MI 49546-8294
(616) 949-8500
(616) 949-2878
Mailing address
2112 EAST PARIS AVE SE, GRAND RAPIDS, MI 49546-8294
(616) 949-8500
(616) 949-2878
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004316
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4879094
—
MI
01
—
JK004316
BCBSM
MI
Enumeration date
04/10/2006
Last updated
12/14/2016
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