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NPI Code Detail

MEDICARE: DR. PETER LOUIS KENNEDY M.D.

MEDICARE:  DR. PETER LOUIS KENNEDY  M.D.
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
1207R00000XInternal Medicine PhysicianME 51561FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1750364410
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PETER LOUIS KENNEDY M.D.
Provider Business Mailing Address
First Line : 8383 N DAVIS HWY
Second Line :
City : PENSACOLA
State : FL
Zip : 32514-6039
Country : US
Telephone Number : 850-494-4112
Fax Number :
Provider Business Practice Location Address
First Line : 8383 N DAVIS HWY
Second Line :
City : PENSACOLA
State : FL
Zip : 32514-6039
Country : US
Telephone Number : 850-494-4112
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/26/2005
Last Update Date : 07/01/2014

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Directions to “ DR. PETER LOUIS KENNEDY M.D.” Practice Location

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