Healthcare Provider Details

I. General information

NPI: 1568528032
Provider Name (Legal Business Name): KENNEDY WHITE & RIGGS ORTHOPEDIC ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 01/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6050 CATTLERIDGE BLVD SUITE 201
SARASOTA FL
34232-6014
US

IV. Provider business mailing address

6050 CATTLERIDGE BLVD SUITE 201
SARASOTA FL
34232-6014
US

V. Phone/Fax

Practice location:
  • Phone: 941-365-0655
  • Fax: 941-366-8043
Mailing address:
  • Phone: 941-365-0655
  • Fax: 941-366-8043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XS0106X
TaxonomyOrthopaedic Hand Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. WILLIAM R KENNEDY III
Title or Position: MANAGING PARTNER
Credential: M.D.
Phone: 941-365-0655