Doctor Name: | JUDITH KENNEDY |
NPI Number: | 1790963494 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 01064765B |
Business Practice Address: | 11123 Parkview Plaza Dr. Suite 101 Fort Wayne, IN - 46845 |
Business Phone Number: | 2604227455 |
Business Fax Number: | |
Mailing Address: | 3926 New Vision Dr, Suite 1 FORT WAYNE |
State: | IN |
Postal Code: | 468451712 |
Phone Number: | 2604227455 |
Fax Number: | 2604585641 |
NPI Enumeration Date: | 02/05/2008 |
NPI Last Update Date: | 05/02/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207V00000X |
License Number: | 01064765B |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | |
Taxonomy Definition: | An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |