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Contact Information

DAVID L KENNEDY, OD
10600 OLD COUNTY ROAD 15
PLYMOUTH, MN55441-6210
 Phone: 763-545-8850
 Fax: 763-544-1257
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
 

Corneal and Contact Management

152WC0802X 41 Optometry
Indicates primary specialty

NPI Profile & details for DAVID L KENNEDY · (Male)

NPI Number 1437250073
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 09/26/2006
Last updated 12/10/2008 - About 17 years ago
Sole proprietor 1 Yes
Identifiers
  • MN License # LD1587000
  • MN License # LF1587000
  • MN Medicaid 963723100
  • MN Other 417R6KE BCBS
  • MN Other 2202707 MEDICA
  • MN Other 977521011194 PREFERRED ONE
Hospital affiliation(s) Not Available
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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