Kennedy, Brent D

Kennedy, Brent D is an sole proprietor health care provider with primary practice located at 5929 Fashion Blvd , Murray UT 84107-7364. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Kennedy, Brent D can be contacted via phone (801) 261-3637.

Contact Information

Primary practice address
5929 Fashion Blvd Murray UT 84107-7364
Phone: (801) 261-3637
Fax: (801) 261-4096
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 0714510013 Utah

Profile Details

NPI number 1174747109
LBN Legal business name Kennedy, Brent D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 12th, 2007
Last updated Nov 12th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1174747109 NPPES
Utah Other 870503471 FEDERAL TAX ID
Utah Other 0714510013 FEDERAL TAX ID
Utah Other AK7813048 FEDERAL TAX ID

Popular Providers