Organization Name: | R. MICHAEL KENNERLY, M.D.,P.A. |
NPI Number: | 1053542720 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | R. MICHAEL KENNERLY (OWNER) |
Mailing Address: | 1298 Cane Creek Rd Fletcher |
State: | NC US |
Postal Code: | 287329467 |
Phone Number: | 8282739584 |
Fax Number: | |
NPI Enumeration Date: | 07/29/2009 |
NPI Last Update Date: | 07/29/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 20026 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |