Kennedy, Thomas James
Kennedy, Thomas James is an sole proprietor health care provider with primary practice located at 527 Medical Park Dr Suite 203, Bridgeport WV 26330-9007. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic Surgery, Allopathic & Osteopathic Physicians / Surgery of the Hand. Allopathic & Osteopathic Physicians / Plastic Surgery is his primary health care specialty. Kennedy, Thomas James can be contacted via phone (681) 342-3190.Contact Information
Primary practice address
527 Medical Park Dr Suite 203
Bridgeport WV 26330-9007
Phone: (681) 342-3190
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic Surgery | 208200000X | WV20534 | West Virginia |
| Allopathic & Osteopathic Physicians / Surgery of the Hand | 2082S0105X | 20534 | West Virginia |
Profile Details
| NPI number | 1215033402 |
|---|---|
| LBN Legal business name | Kennedy, Thomas James |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 15th, 2006 |
| Last updated | Jun 8th, 2011 - 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 | 1215033402 | NPPES |
| West Virginia | Other | 550781237 | TAX ID |
| West Virginia | Other | 350670000 | TAX ID |
| West Virginia | MEDICAID | 3002519000 | TAX ID |
| West Virginia | Other | WV20534 | TAX ID |
| West Virginia | Other | 1056649 | TAX ID |
| West Virginia | Other | 001722749 | TAX ID |
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