Kennedy, Philip R
Kennedy, Philip R is an sole proprietor health care provider with primary practice located at 3400 Mcclure Bridge Rd Suite D401, Duluth GA 30096-6675. He recently has only one registered license in Allopathic & Osteopathic Physicians / Neurology, which is considered as his primary health care specialty. Kennedy, Philip R can be contacted via phone (770) 622-2230.Contact Information
Primary practice address
3400 Mcclure Bridge Rd Suite D401
Duluth GA 30096-6675
Phone: (770) 622-2230
Fax: (770) 622-9741
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neurology | 2084N0400X | GA03970B | Georgia |
Profile Details
| NPI number | 1912903485 |
|---|---|
| LBN Legal business name | Kennedy, Philip R |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 21st, 2005 |
| Last updated | Jan 23rd, 2009 - about 15 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 | 1912903485 | NPPES |
| Georgia | MEDICAID | 000772813A |
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