Individual
DR. RICHARD THOMAS KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
169 NORTH SECOND AVE, HARTFORD, AL 36344
(334) 588-2084
(334) 588-2168
Mailing address
1803 BETHLEHEM RD, MIDLAND CITY, AL 36350-6013
(334) 983-1864
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
00008459
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
515-26056
BLUE CROSS / BLUE SHIELD
AL
01
—
P00179451
MEDICARE RAILROAD
AL
Enumeration date
07/13/2006
Last updated
07/09/2007
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