Organization
D &L K INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN W KENNEDY MD (OWNER)
(765) 834-4057
Entity
Organization
Contact information
Practice address
1316 N LEXINGTON RD, MARION, IN 46952-9342
(765) 834-4057
Mailing address
1316 N LEXINGTON RD, MARION, IN 46952-9342
(765) 834-4057
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01022780
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200884550
—
IN
Enumeration date
12/28/2007
Last updated
12/29/2014
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