Kennedy, Thomas James

Kennedy, Thomas James is an sole proprietor health care provider with primary practice located at 527 Medical Park Dr Suite 203, Bridgeport WV 26330-9007. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery, Allopathic & Osteopathic Physicians / Surgery of the Hand. Allopathic & Osteopathic Physicians / Plastic Surgery is his primary health care specialty. Kennedy, Thomas James can be contacted via phone (681) 342-3190.

Contact Information

Primary practice address
527 Medical Park Dr Suite 203 Bridgeport WV 26330-9007
Phone: (681) 342-3190
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X WV20534 West Virginia
Allopathic & Osteopathic Physicians / Surgery of the Hand 2082S0105X 20534 West Virginia

Profile Details

NPI number 1215033402
LBN Legal business name Kennedy, Thomas James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 15th, 2006
Last updated Jun 8th, 2011 - about 13 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 1215033402 NPPES
West Virginia Other 550781237 TAX ID
West Virginia Other 350670000 TAX ID
West Virginia MEDICAID 3002519000 TAX ID
West Virginia Other WV20534 TAX ID
West Virginia Other 1056649 TAX ID
West Virginia Other 001722749 TAX ID

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