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Individual

JOHN TERRANCE KENNY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
210 E GRAY ST, SUITE 1002, LOUISVILLE, KY 40202-3900
(502) 584-2029
(502) 584-0873
Mailing address
PO BOX 766351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
01042682
IN
207RC0000X
Cardiovascular Disease Physician
Primary
26475
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000049366
ANTHEM
KY
01
000057094P
HUMANA - CTS
KY
01
060022400
RAILROAD MEDICARE
KY
05
100344720
IN
05
1050456
KY
01
2432852000
PASSPORT ADVANTAGE
KY
01
50031703
PASSPORT/PASSPORT ADVTG - CTS
KY
01
5921
SIHO - CTS
KY
05
64264757
KY
Enumeration date
05/16/2006
Last updated
01/19/2021
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