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General NPI Number Information
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NPI Number | 1487278909
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Entity Type | Individual
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Provider Name | ROBERT KENNEDY
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Gender | Male
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Dates
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Enumeration Date | 06/01/2020
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 201 SIVLEY RD SW STE 440
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City | HUNTSVILLE
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State | AL
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Zip | 35801-5165
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Country | US
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Telephone | 256-265-0780
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Fax |
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Provider Business Mailing Address
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Address Line | 1120 15TH ST # OR6000
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City | AUGUSTA
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State | GA
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Zip | 30912-0004
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Country | US
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Telephone | 706-721-3813
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 96084
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 11874
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 4115
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License Number State | AL
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