Individual
JAY KELLY KENNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
525 AIRPORT DR, ONEIDA, WI 54155-9035
(920) 869-2711
(920) 869-1077
Mailing address
PO BOX 365, ONEIDA, WI 54155-0365
(920) 869-2711
(920) 869-1077
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
35.073508
OH
207Q00000X
Family Medicine Physician
Primary
49185-020
WI
Other
Enumeration date
07/07/2005
Last updated
06/08/2012
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