Kennedy, Craig

Kennedy, Craig is an individual health care provider with primary practice located at 1400 E Wade Watts Ave , Mcalester OK 74501-5652. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Kennedy, Craig can be contacted via phone (918) 429-1400.

Contact Information

Primary practice address
1400 E Wade Watts Ave Mcalester OK 74501-5652
Phone: (918) 429-1400
Fax: (918) 429-1403
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 2160 Oklahoma

Profile Details

NPI number 1992768113
LBN Legal business name Kennedy, Craig
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 10th, 2006
Last updated Dec 30th, 2022 - about 4 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1992768113 NPPES
Oklahoma Other 0166707 UMWA
Oklahoma MEDICAID 100763340B UMWA
Oklahoma Other 1324230001 UMWA
Oklahoma Other 74502A002 UMWA
Oklahoma Other U56560 UMWA
Oklahoma Other 731310891006 UMWA
Oklahoma Other 731310891028 UMWA

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