Kennedy, Jasiri

Kennedy, Jasiri is an individual health care provider with primary practice located at 1325 Broadway St , Rockport TX 78382-3333. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Kennedy, Jasiri can be contacted via phone (361) 729-0646.

Contact Information

Primary practice address
1325 Broadway St Rockport TX 78382-3333
Phone: (361) 729-0646
Fax: (361) 729-8854
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X L4016 Texas
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X L4016 Texas
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X A81294 California
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 036-098701 Illinois

Profile Details

NPI number 1972583185
LBN Legal business name Kennedy, Jasiri
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 23rd, 2006
Last updated Dec 19th, 2008 - about 16 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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Identifiers

StateTypeNumberIssuer
All States NPI 1972583185 NPPES
Illinois MEDICAID 036098701
Illinois MEDICAID 00A812940
Illinois Other 3932056

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