Kennedy, Brent D
Kennedy, Brent D is an sole proprietor health care provider with primary practice located at 5929 Fashion Blvd , Murray UT 84107-7364. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Kennedy, Brent D can be contacted via phone (801) 261-3637.Contact Information
Primary practice address
5929 Fashion Blvd
Murray UT 84107-7364
Phone: (801) 261-3637
Fax: (801) 261-4096
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | 0714510013 | Utah |
Profile Details
| NPI number | 1174747109 |
|---|---|
| LBN Legal business name | Kennedy, Brent D |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 12th, 2007 |
| Last updated | Nov 12th, 2012 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174747109 | NPPES |
| Utah | Other | 870503471 | FEDERAL TAX ID |
| Utah | Other | 0714510013 | FEDERAL TAX ID |
| Utah | Other | AK7813048 | FEDERAL TAX ID |
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