Kennedy, David Lawrence
Kennedy, David Lawrence is an sole proprietor health care provider with primary practice located at 10600 Old County Road 15 , Plymouth MN 55441-6210. He recently has 2 registered licenses in different health care specialties including Eye and Vision Services Providers / Optometrist, Eye and Vision Services Providers / Corneal and Contact Management. Eye and Vision Services Providers / Optometrist is his primary health care specialty. Kennedy, David Lawrence can be contacted via phone (763) 545-8850.Contact Information
Primary practice address
10600 Old County Road 15
Plymouth MN 55441-6210
Phone: (763) 545-8850
Fax: (763) 544-1257
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | LF1587000 | Minnesota |
| Eye and Vision Services Providers / Corneal and Contact Management | 152WC0802X | LD1587000 | Minnesota |
Profile Details
| NPI number | 1437250073 |
|---|---|
| LBN Legal business name | Kennedy, David Lawrence |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 26th, 2006 |
| Last updated | Dec 10th, 2008 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437250073 | NPPES |
| Minnesota | Other | 417R6KE | BCBS |
| Minnesota | Other | 2202707 | BCBS |
| Minnesota | MEDICAID | 963723100 | BCBS |
| Minnesota | Other | 977521011194 | BCBS |
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