Healthcare Provider Details

I. General information

NPI: 1447887971
Provider Name (Legal Business Name): CONNOR L KENNEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/25/2020
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

877 JEFFERSON AVE
MEMPHIS TN
38103-2807
US

IV. Provider business mailing address

920 MADISON AVE STE 447
MEMPHIS TN
38103-3438
US

V. Phone/Fax

Practice location:
  • Phone: 901-448-5364
  • Fax:
Mailing address:
  • Phone: 901-448-5364
  • Fax: 901-448-6182

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0101274657
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: