Individual provider · Type 1 NPI
Elaine Kennedy, MD
Pediatric Adolescent Medicine Physician · Tahlequah, OK
Practice location
100 S Bliss Ave, Pediatrics Clinic
Tahlequah, OK 74464-2512
Mailing address
1390 Heritage Ln, Pleasant View Apts # 92
Tahlequah, OK 74464-2136
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | 22124 (WV) |
| Pediatric Adolescent Medicine Physician | 2080A0000X | 34616 (KY) |
| Pediatric Adolescent Medicine Physician | 2080A0000X | 21310 (SC) |
| Pediatric Adolescent Medicine Physician Primary | 2080A0000X | 044765 (GA) |
| Pediatric Adolescent Medicine Physician | 2080A0000X | 00022200 (AL) |
| Pediatric Adolescent Medicine Physician | 2080A0000X | MD0000010129 (TN) |
Pediatric Adolescent Medicine Physician: A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
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About NPI 1083634935
Elaine Kennedy, MD's National Provider Identifier is 1083634935, issued on Jul 20, 2006. The primary taxonomy on file is Pediatric Adolescent Medicine Physician (2080A0000X), and the practice location is in Tahlequah, OK. The record was last updated on Jan 6, 2011.