Kennedy, Elaine

Kennedy, Elaine is an individual health care provider with primary practice located at 100 S Bliss Ave Pediatrics Clinic, Tahlequah OK 74464-2512. She recently has only one registered license in Allopathic & Osteopathic Physicians / Adolescent Medicine, which is considered as her primary health care specialty. Kennedy, Elaine can be contacted via phone (918) 458-3120.

Contact Information

Primary practice address
100 S Bliss Ave Pediatrics Clinic Tahlequah OK 74464-2512
Phone: (918) 458-3120
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 22124 West Virginia
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 34616 Kentucky
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 21310 South Carolina
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 044765 Georgia
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X 00022200 Alabama
Allopathic & Osteopathic Physicians / Adolescent Medicine 2080A0000X MD0000010129 Tennessee

Profile Details

NPI number 1083634935
LBN Legal business name Kennedy, Elaine
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 20th, 2006
Last updated Jan 6th, 2011 - about 14 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.

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