Individual
MICHAEL PATRICK KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 SAINT CHARLES ST, CARENCRO, LA 70520-4004
(337) 886-1200
(337) 886-0919
Mailing address
111 SAINT CHARLES ST, CARENCRO, LA 70520-0000
(337) 886-1200
(337) 886-0919
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD018238
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10990532
CAQH
—
05
—
1377104
—
LA
01
—
7299329
AETNA
—
01
—
F4181
BLUE CROSS
LA
Enumeration date
08/09/2006
Last updated
12/09/2009
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