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Contact Information

KENNETH J EADDY, MD
3750 SAN JOSE PL STE 35
JACKSONVILLE, FL32257-8861
 Phone: 904-902-4126
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Interventional Pain Medicine

208VP0014X 09 Physician/Interventional Pain Management
 

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KENNETH J EADDY · (Male)

NPI Number 1154506376
Status Active
Credentials MD
Entity Individual
Enumeration date 01/07/2008
Last updated 04/24/2023 - About 3 years ago
Sole proprietor 1 No
Identifiers
  • FL License # ME107723
Hospital affiliation(s)
  • BAPTIST MEDICAL CENTER - (Acute Care)
    800 PRUDENTIAL DR
    JACKSONVILLE, FL 32207
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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