Kennedy, John Wayne

Kennedy, John Wayne is an individual health care provider with primary practice located at 1614 N Baldwin Ave , Marion IN 46952-1437. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Kennedy, John Wayne can be contacted via phone (765) 664-9000.

Contact Information

Primary practice address
1614 N Baldwin Ave Marion IN 46952-1437
Phone: (765) 664-9000
Fax: (765) 391-1521
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 01022780 Indiana
Allopathic & Osteopathic Physicians / General Practice 208D00000X 01022780A Indiana

Profile Details

NPI number 1780665448
LBN Legal business name Kennedy, John Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 9th, 2005
Last updated Feb 15th, 2013 - about 12 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1780665448 NPPES
Indiana Other 000000576122 BCBS
Indiana Other 000000697935 BCBS
Indiana MEDICAID 100123680 BCBS
Indiana Other 000000286588 BCBS

Popular Providers