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General NPI Number Information
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NPI Number | 1114508777
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Entity Type | Individual
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Provider Name | PABLO ANDRES KENNEDY MD
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Gender | Male
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Dates
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Enumeration Date | 04/15/2021
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1102 SAINT MARYS RD
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City | JUNCTION CITY
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State | KS
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Zip | 66441-4139
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Country | US
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Telephone | 785-238-0325
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Fax | 785-576-1113
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Provider Business Mailing Address
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Address Line | 4717 SW WANAMAKER RD
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City | TOPEKA
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State | KS
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Zip | 66610-1333
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Country | US
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Telephone | 785-438-9023
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number | 04-50055
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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