| Kennebunk Family Practice, Llc | |
|
9 High St Kennebunk ME 04043-7164 | |
| (207) 502-7220 | |
| (207) 502-7220 |
| Full Name | Kennebunk Family Practice, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 9 High St, Kennebunk, Maine |
| Authorized Official Name and Position | Cecily Cannon (PHYSICIAN) |
| Authorized Official Contact | 2072295789 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kennebunk Family Practice, Llc 103 Summer St Kennebunk ME 04043-6613 Ph: (207) 229-5789 | Kennebunk Family Practice, Llc 9 High St Kennebunk ME 04043-7164 Ph: (207) 502-7220 |
| NPI Number | 1568883429 |
|---|---|
| Provider Enumeration Date | 12/19/2013 |
| Last Update Date | 01/28/2014 |
| Medicare PECOS PAC ID | 7012133531 |
|---|---|
| Medicare Enrollment ID | O20140718000794 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1568883429 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 2043 (Maine) | Primary |
| Provider Name | Cecily Cannon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1700076908 PECOS PAC ID: 9234299587 Enrollment ID: I20081117000760 |
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