MEDICARE: MERLE L KENNEDY MD

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
1	207X00000X	Orthopaedic Surgery Physician	35047762K	OH
2	207XS0114X	Adult Reconstructive Orthopaedic Surgery Physician	35047762K	OH
3	207XX0005X	Sports Medicine (Orthopaedic Surgery) Physician	35047762K	OH

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	KE0731251	OTHER	OH	RAILROAD MEDICARE
7	1376868448	OTHER	OH	MEDICARE DME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000120033	OTHER	OH	ANTHEM PIN
2	09-00371	OTHER	OH	UHC PIN
3	4066846	OTHER	OH	AETNA PIN
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	1881292-002	OTHER	OH	CIGNA PIN

General Provider Information

NPI Number	:	1558324160
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MERLE L KENNEDY MD

Provider Business Mailing Address
First Line	:	560 N CLEVELAND AVE
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43082-9105
Country	:	US
Telephone Number	:	614-839-2300
Fax Number	:	614-839-2301

Provider Business Practice Location Address
First Line	:	560 N CLEVELAND AVE
Second Line	:
City	:	WESTERVILLE
State	:	OH
Zip	:	43082-9105
Country	:	US
Telephone Number	:	614-839-2300
Fax Number	:	614-839-2301

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	05/13/2013

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Directions to “ MERLE L KENNEDY MD” Practice Location

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