Individual
RAYMOND JAMES KENNEDY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2040 WOODWINDS DR, WOODBURY, MN 55125-2522
(651) 259-9750
Mailing address
2040 WOODWINDS DR, WOODBURY, MN 55125-2522
(651) 259-9750
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
39653
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038460700
—
MN
01
—
1501790
MEDICA
MN
01
—
991N7KE
BCBS OF MN
MN
Enumeration date
11/21/2005
Last updated
01/09/2024
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