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Contact Information

RONALD KENNEDY, MD
971 LAKELAND DR STE 657
JACKSON, MS39216-4608
 Phone: 601-200-2780
 Fax: 601-200-2788
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Thoracic Surgery (Cardiothoracic Vascular Surgery)

208G00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for RONALD KENNEDY · (Male)

NPI Number 1689725202
Status Active
Credentials MD
Entity Individual
Enumeration date 01/12/2007
Last updated 05/08/2025 - More than a year ago
Sole proprietor 1 No
Identifiers
  • LA License # 326463
  • MS License # 08369
  • MS Medicaid 0116208
Hospital affiliation(s)
  • ST DOMINIC-JACKSON MEMORIAL HOSPITAL - (Acute Care)
    969 LAKELAND DR
    JACKSON, MS 39216
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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