Provider Demographics
NPI:1093007544
Name:KENNEDY WHITE & RIGGS ORTHOPEDIC ASSOCIATES
Entity Type:Organization
Organization Name:KENNEDY WHITE & RIGGS ORTHOPEDIC ASSOCIATES
Other - Org Name:KENNEDY-WHITE ORTHOPAEDIC CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:941-365-0655
Mailing Address - Street 1:6050 CATTLERIDGE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34232-6028
Mailing Address - Country:US
Mailing Address - Phone:941-365-0655
Mailing Address - Fax:941-366-8043
Practice Address - Street 1:1921 WALDEMERE ST 401
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2941
Practice Address - Country:US
Practice Address - Phone:941-365-0655
Practice Address - Fax:941-366-8043
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KENNEDY WHITE & RIGGS ORTHOPEDIC ASSOCIATES
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-05-03
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME16093332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL4961480001Medicare NSC