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Individual

DR. JAMES A. KENNEY JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1800 12TH ST, MERIDIAN, MS 39301-4158
(601) 703-9928
Mailing address
1800 12TH ST, MERIDIAN, MS 39301-4158
(601) 703-9928

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
F57233
MS
2085R0204X
Vascular & Interventional Radiology Physician
15132
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00118270
MS
01
009712630
ALABAMA MEDICAID
AL
01
300071940
RAILROAD MEDICARE
01
73099313
BLUE CROSS OF AL
AL
Enumeration date
08/19/2005
Last updated
09/15/2008
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