Dr. Thomas James Kennedy III
Surgeon Plastic Hand Surgeon
527 Medical Park Dr Suite 203
Bridgeport
, West Virginia 26330-9007
Dr. Thomas James Kennedy III
Surgeon Plastic Hand Surgeon
527 Medical Park Dr Suite 203
Bridgeport
, West Virginia 26330-9007
(681) 342-3195
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About
Features
Specialties
- Surgeon
- Plastic Hand Surgeon
Languages spoken
- English
Location
First Address
- Dr. Thomas James Kennedy III
- 527 Medical Park Dr Suite 203
- Bridgeport, WV
- Zip : 26330-9007
- Fax : (681) 342-3195
- Phone : (681) 342-3190
Second Address
- Dr. Thomas James Kennedy III
- 527 Medical Park Dr Suite 203
- Bridgeport, WV
- Zip : 26330-9007
- Phone : (681) 342-3190
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Is Dr. Thomas James Kennedy III a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208200000X | Surgeon | WV20534 | WV |
| Y | 208600000X | Surgeon | WV20534 | WV |
| N | 2082S0105X | Plastic Hand Surgeon | 20534 | WV |
National Provider Identifier
| NPI | 1215033402 |
|---|---|
| Provider Name | Dr. Thomas James Kennedy III |
| First Address | Bridgeport, WV 26330-9007 |
| Second Address | Bridgeport, WV 26330-9007 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 15/09/2006 |
| Last Update Date | 08/06/2011 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 001722749 | BLUE CROSS/BLUE SHIELD (01) | WV |
| 1056649 | WORKER'S COMP BRICK ST (01) | WV |
| 3002519000 | (05) | WV |
| 350670000 | FEDWORKER'S COMPENSATION (01) | WV |
| 550781237 | TAX ID (01) | WV |
| A42220 | (02) | WV |
| WV20534 | HEALTH PLAN (01) | WV |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.