Individual
DR. PHILIP R KENNEDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3400 MCCLURE BRIDGE RD, SUITE D401, DULUTH, GA 30096-6675
(770) 622-2230
(770) 622-9741
Mailing address
3400 MCCLURE BRIDGE RD, SUITE D401, DULUTH, GA 30096-6675
(770) 622-2230
(770) 622-9741
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
GA03970B
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000772813A
—
GA
Enumeration date
06/21/2005
Last updated
01/23/2009
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