| Dr Michael Kennedy Family Practice | |
|
111 Saint Charles St Carencro LA 70520-4004 | |
| (337) 886-1200 | |
| (337) 886-0919 |
| Full Name | Dr Michael Kennedy Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 111 Saint Charles St, Carencro, Louisiana |
| Authorized Official Name and Position | Michael Patrick Kennedy (CEO OWNER) |
| Authorized Official Contact | 3378861200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael Kennedy Family Practice 111 Saint Charles St Carencro LA 70520-4004 Ph: (337) 886-1200 | Dr Michael Kennedy Family Practice 111 Saint Charles St Carencro LA 70520-4004 Ph: (337) 886-1200 |
| NPI Number | 1740291624 |
|---|---|
| Provider Enumeration Date | 08/10/2006 |
| Last Update Date | 12/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740291624 | NPI | - | NPPES |
| 1377104 | Medicaid | LA | |
| 7299329 | Other | LA | AETNA |
| 10990532 | Other | LA | CAQH |
| F4181 | Other | LA | BLUE CROSS BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | MD018238 (Louisiana) | Primary |
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