Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ELAINE KENNEDY, M.D.
ActiveDR. ELAINE KENNEDY, M.D. is a Adolescent Medicine (Pediatrics) healthcare provider located in TAHLEQUAH, Oklahoma. NPI 1083634935 is currently active in the NPPES registry. Verify at CMS.
Adolescent Medicine (Pediatrics) · TAHLEQUAH, OK
Registration Details
- NPI Number
- 1083634935
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jul 20, 2006 (20.097889675092 yrs)
- Last Updated
- Jan 6, 2011
- Licenses
-
22124 (WV)34616 (KY)21310 (SC)044765 (GA)00022200 (AL)
Practice Information
- Address
-
100 S BLISS AVEPEDIATRICS CLINICTAHLEQUAH, OK, 744642512Browse OK providers · Browse ZIP 74464
- Phone
- 9184583120
- Primary Specialty
-
Adolescent Medicine (Pediatrics)
2080A0000X
- Additional Specialty
- Adolescent Medicine (Pediatrics)
- Additional Specialty
- Adolescent Medicine (Pediatrics)
- Additional Specialty
- Adolescent Medicine (Pediatrics)
- Additional Specialty
- Adolescent Medicine (Pediatrics)
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.