Wilton Craig Kennedy in Roanoke - Medical
Wilton Craig Kennedy - NPI 1154475267
Wilton Craig Kennedy is a Medical in Roanoke, Virginia. Wilton Craig Kennedy practices all healthcare services and medical treatments related to Medical. The NPI Number for Wilton Craig Kennedy is 1154475267. The last update date is 2007-07-08.
Wilton Craig Kennedy's current location address is 2620 Avenham Ave Sw, Roanoke, Virginia. You can contact this provider via phone number 5409854016. The mailing address for Wilton Craig Kennedy is 2620 Avenham Ave Sw, Roanoke, Virginia. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Wilton Craig Kennedy |
|---|---|
| Address | 2620 Avenham Ave Sw, Roanoke, Virginia |
| Phone Number | 5409854016 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA-C |
NPI Number Detail
| NPI Number | 1154475267 |
|---|---|
| Provider Enumeration Date | 2007-01-23 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2620 Avenham Ave Sw |
|---|---|
| City | Roanoke |
| State | Virginia (VA) |
| Post Code | 240141507 |
| Phone Number | 5409854016 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | 0110 001184 |
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Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
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Post Comment/ Review Below
What is the unique provider identifier assigned to Wilton Craig Kennedy?
The Wilton Craig Kennedy has been issued the NPI (National Provider Identifier) 1154475267 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you please provide the complete street address where Wilton Craig Kennedy is physically located?
The Wilton Craig Kennedy is physically situated at the following address: 2620 Avenham Ave Sw, Roanoke, VA, 240141507.
What is the Wilton Craig Kennedy's specialty and taxonomy code?
The Wilton Craig Kennedy's specialty is Medical, and the corresponding taxonomy code is 363Am0700X.
On what date did the Wilton Craig Kennedy receive its 1154475267 assignment from the Centers for Medicare & Medicaid Services?
The Wilton Craig Kennedy was assigned its 1154475267 by the Centers for Medicare & Medicaid Services on 2007-01-23.
As of what date were the details pertaining to Wilton Craig Kennedy last refreshed?
The information related to the Wilton Craig Kennedy, including its address, specialty, and other relevant details, was last updated on 2007-07-08.