Individual
TIMOTHY KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6701 AIRPROT BLVD, STE A101, MOBILE, AL 36608-0000
(251) 633-8880
(251) 378-6222
Mailing address
1200 SOMERBY DR APT 1507, MOBILE, AL 36695-5442
(251) 554-4174
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36695
AL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/19/2016
Last updated
08/29/2019
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