| Dr Thomas James Kennedy Iii, MD | |
|
527 Medical Park Dr, Suite 203, Bridgeport, WV 26330-9007 | |
| (681) 342-3190 | |
| Not Available |
| Full Name | Dr Thomas James Kennedy Iii |
|---|---|
| Gender | Male |
| Speciality | Plastic Surgery |
| Location | 527 Medical Park Dr, Bridgeport, West Virginia |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215033402 | NPI | - | NPPES |
| 550781237 | Other | WV | TAX ID |
| 350670000 | Other | WV | FEDWORKER'S COMPENSATION |
| 3002519000 | Medicaid | WV | |
| WV20534 | Other | WV | HEALTH PLAN |
| 1056649 | Other | WV | WORKER'S COMP BRICK ST |
| 001722749 | Other | WV | BLUE CROSS/BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208200000X | Plastic Surgery | WV20534 (West Virginia) | Primary |
| 2082S0105X | Plastic Surgery - Surgery Of The Hand | 20534 (West Virginia) | Secondary |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Thomas James Kennedy Iii, MD 527 Medical Park Dr, Suite 203, Bridgeport, WV 26330-9007 Ph: (681) 342-3190 | Dr Thomas James Kennedy Iii, MD 527 Medical Park Dr, Suite 203, Bridgeport, WV 26330-9007 Ph: (681) 342-3190 |
Dr. Ronald William Luethke, M.D. Plastic Surgery Medicare: Accepting Medicare Assignments Practice Location: 527 Medical Park Dr Ste 203, Bridgeport, WV 26330 Phone: 681-342-3190 Fax: 681-342-3195 |