Provider Demographics
NPI:1437185543
Name:KENNEY, ROBERT J JR (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:KENNEY
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:901 E 104TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-502-7000
Mailing Address - Fax:816-932-9670
Practice Address - Street 1:5844 NW BARRY RD STE 120
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64154-1483
Practice Address - Country:US
Practice Address - Phone:816-472-9595
Practice Address - Fax:816-472-1132
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2019-03-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2005018417208600000X
KS05-34228208600000X
MO2010005331208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO568912OtherCOVENTRY
MO3195109OtherUNITED HEALTHCARE
MO122039OtherHEALTHCARE USA
MO44172024OtherBCBS OF KC
MO745980OtherMISSOURI CARE