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Individual

DR. STEPHEN WILLIAM KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9300 W STOCKTON BLVD, STE 104, ELK GROVE, CA 95758-8070
(916) 691-2069
(916) 691-2065
Mailing address
9300 W STOCKTON BLVD, STE 104, ELK GROVE, CA 95758-8070
(916) 691-2069
(916) 691-2065

Taxonomy

Speciality
Code
Description
License number
State
2471B0102X
Bone Densitometry Radiologic Technologist
Primary
A86061
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1629188941
MEDICARE NPI - ORGANIZATION
Enumeration date
09/09/2005
Last updated
11/09/2009
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