Individual
DR. CHARLES WILLIAM KENNEDY IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 539-5545
Mailing address
3551 ROGER BROOKE DR, JBSA FT SAM HOUSTON, TX 78234-4504
(210) 539-5545
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101281057
VA
Other
Enumeration date
02/15/2022
Last updated
01/29/2024
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