Individual
MR. HOWARD MICHAEL KENNEDY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4957 SWINYAR DR STE 109, OOLTEWAH, TN 37363-2205
(423) 432-3130
(423) 396-9508
Mailing address
4957 SWINYAR DR STE 109, OOLTEWAH, TN 37363-2205
(423) 432-3130
(423) 396-9508
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
408
TN
363AM0700X
Medical Physician Assistant
408
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36660801
—
TN
Enumeration date
01/17/2006
Last updated
01/26/2024
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