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General NPI Number Information
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NPI Number | 1851579304
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Entity Type | Individual
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Provider Name | JOEY THOMAS KENNEY MD
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Gender | Male
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Dates
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Enumeration Date | 02/07/2008
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Last Update Date | 02/08/2019
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Provider Practice Location Address
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Address Line | 3649 CORTEZ RD W
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City | BRADENTON
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State | FL
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Zip | 34210-3106
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Country | US
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Telephone | 941-753-7585
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Fax | 941-758-2153
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Provider Business Mailing Address
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Address Line | PO BOX 20415
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City | BRADENTON
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State | FL
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Zip | 34204-0415
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Country | US
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Telephone | 941-753-7585
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Fax | 941-758-2153
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | ME67656
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License Number State | FL
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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 | ME67656
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License Number State | FL
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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 | 146083
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License Number State | CA
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