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General NPI Number Information
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NPI Number | 1285383539
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Entity Type | Individual
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Provider Name | JASPER TRUETT KENNEDY MD
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Gender | Female
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Dates
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Enumeration Date | 03/23/2022
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 535 JACK WARNER PKWY NE STE I
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City | TUSCALOOSA
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State | AL
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Zip | 35404-5751
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Country | US
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Telephone | 205-556-2026
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Fax |
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Provider Business Mailing Address
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Address Line | 1619 14TH AVE S APT 1B
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City | BIRMINGHAM
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State | AL
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Zip | 35205-5592
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Country | US
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Telephone |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 51632
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License Number State | AL
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