Individual
JOHN I KENNEDY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-6600
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310
(205) 731-9701
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
10553
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000012159
BLUE CROSS
AL
05
—
000012159
—
AL
01
—
020003995
RAILROAD MEDICARE
AL
01
—
22518
HEALTHSPRING OF ALABAMA
AL
01
—
C73561
VIVA
AL
Enumeration date
06/29/2006
Last updated
07/13/2011
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