Individual
DR. DAMON MARK KENNEDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4802 E JOHNSON AVE, JONESBORO, AR 72405-8413
(870) 936-8000
(870) 934-3628
Mailing address
PO BOX 1960, JONESBORO, AR 72403-1960
(870) 936-8000
(870) 934-3628
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
47892
CO
208600000X
Surgery Physician
DR.0047892
CO
2086S0120X
Pediatric Surgery Physician
47892
CO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
10460A
WY
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
DR.0047892
CO
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
E-18514
AR
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
L2368
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025839700
—
NE
05
—
68856750
—
CO
Enumeration date
06/28/2006
Last updated
01/22/2025
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