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Individual

JAMES A KENNEDY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
2802 ROSS CLARK CIRCLE, DOTHAN, AL 36301
(334) 793-5105
Mailing address
1118 ROSS CLARK CIRCLE, STE 700, DOTHAN, AL 36301
(334) 793-5105
(334) 671-5073

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
1024643
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000055576
AL
05
00868293A
GA
01
51055576
BCBS
AL
Enumeration date
01/11/2006
Last updated
10/19/2011
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