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NPI Code Detail

MEDICARE: KATIE NEWTON KENNEDY DO

MEDICARE: KATIE NEWTON KENNEDY DO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RH0003XHematology & Oncology PhysicianMDO.91352.DOSC

General Provider Information

NPI Number : 1104357698
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE NEWTON KENNEDY DO
Provider Business Mailing Address
First Line : 4181 HIGHWAY 17
Second Line :
City : MURRELLS INLET
State : SC
Zip : 29576-5019
Country : US
Telephone Number : 843-652-3600
Fax Number :
Provider Business Practice Location Address
First Line : 4181 HIGHWAY 17
Second Line :
City : MURRELLS INLET
State : SC
Zip : 29576-5019
Country : US
Telephone Number : 843-652-3600
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2017
Last Update Date : 12/11/2025

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