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DR. CRAIG ALLEN KENNEDY MD

>> Emergency Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1356332555

Individual Registrant:
DR. CRAIG ALLEN KENNEDY MD
Gender: M
Sole Proprietor

Location and contact information for practice:
1530 BIXBY RD  MOUNDS, OK 74047-5335 US
Tel: 918-366-9152  Fax: 918-366-1170

Contact information for business:
1530 BIXBY RD  MOUNDS, OK 74047-5335 US
Tel: 918-366-9152  Fax: 918-366-1170

Registration Information:
NPI: 1356332555
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207P00000XAllopathic & Osteopathic Physicians
Emergency Medicine
OK14981

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
100790580DOK05
RAILROAD MEDICARE930085465OK01




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