Healthcare Provider Details

I. General information

NPI: 1083052856
Provider Name (Legal Business Name): AIMEE ADAIR KENNEDY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2013
Last Update Date: 06/04/2025
Certification Date: 06/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3333 BURNET AVE # 9016
CINCINNATI OH
45229-3026
US

IV. Provider business mailing address

3333 BURNET AVE # 9016
CINCINNATI OH
45229-3026
US

V. Phone/Fax

Practice location:
  • Phone: 337-739-0689
  • Fax:
Mailing address:
  • Phone: 337-739-0689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number036151912
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number35.153559
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: