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General NPI Number Information
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NPI Number | 1659291532
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Entity Type | Organization
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Legal Business Name | KENNEDY FACIAL PLASTIC SURGERY
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Dates
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Enumeration Date | 07/20/2026
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Last Update Date | 07/20/2026
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Provider Practice Location Address
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Address Line | 550 LAKES BLVD
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City | BREAUX BRIDGE
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State | LA
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Zip | 70517-3240
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Country | US
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Telephone | 337-761-3361
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Fax |
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Provider Business Mailing Address
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Address Line | 550 LAKES BLVD
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City | BREAUX BRIDGE
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State | LA
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Zip | 70517-3240
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Country | US
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Telephone | 337-761-3361
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Fax |
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Authorized Official
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Title or Position | OWNER, FACIAL PLASTIC SURGEON
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Name | DR. PAIGE MARIE KENNEDY
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Credential | MD
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Telephone | 337-781-9728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207YS0123X
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Taxonomy Name | Facial Plastic Surgery Physician
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License Number |
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License Number State |
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