Kennedy, Thomas C

Kennedy, Thomas C is an individual health care provider with primary practice located at 111 S 11Th Ave Ste 320 , Yakima WA 98902-3273. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Kennedy, Thomas C can be contacted via phone (509) 454-8888.

Contact Information

Primary practice address
111 S 11Th Ave Ste 320 Yakima WA 98902-3273
Phone: (509) 454-8888
Fax: (509) 453-0061
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X MD00028021 Washington

Profile Details

NPI number 1902872500
LBN Legal business name Kennedy, Thomas C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 24th, 2006
Last updated Jan 26th, 2023 - about 2 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 1902872500 NPPES
Washington MEDICAID 1046130

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