Provider Demographics
NPI:1508848268
Name:KENNEY, JOHN D III (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:D
Last Name:KENNEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10301 HICKMAN MILLS DR
Mailing Address - Street 2:100
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64137-1674
Mailing Address - Country:US
Mailing Address - Phone:816-763-5446
Mailing Address - Fax:816-763-8426
Practice Address - Street 1:5721 W 119TH ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66209-3722
Practice Address - Country:US
Practice Address - Phone:816-763-5446
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR6641207L00000X
KS04-19101207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS0133781Medicare ID - Type Unspecified
KSC52221Medicare UPIN