Kennedy, Phillip S

Kennedy, Phillip S is an individual health care provider with primary practice located at 3614 D J Dewey Gray Circle , Augusta GA 30909. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kennedy, Phillip S can be contacted via phone (706) 868-7380.

Contact Information

Primary practice address
3614 D J Dewey Gray Circle Augusta GA 30909
Phone: (706) 868-7380
Fax: (706) 868-7223
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 043985 Georgia

Profile Details

NPI number 1609817618
LBN Legal business name Kennedy, Phillip S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated May 23rd, 2024 - about last year

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 1609817618 NPPES
Georgia MEDICAID 00793922A
Georgia Other 336986
Georgia MEDICAID G43985
Georgia Other 043985
Georgia Other CH0654
Georgia Other 10056165

Popular Providers