Provider Demographics
NPI:1851579304
Name:KENNEY, JOEY THOMAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEY
Middle Name:THOMAS
Last Name:KENNEY
Suffix:
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:PO BOX 20415
Mailing Address - Street 2:
Mailing Address - City:BRADENTON
Mailing Address - State:FL
Mailing Address - Zip Code:34204-0415
Mailing Address - Country:US
Mailing Address - Phone:941-753-7585
Mailing Address - Fax:941-758-2153
Practice Address - Street 1:3649 CORTEZ RD W
Practice Address - Street 2:
Practice Address - City:BRADENTON
Practice Address - State:FL
Practice Address - Zip Code:34210-3106
Practice Address - Country:US
Practice Address - Phone:941-753-7585
Practice Address - Fax:941-758-2153
Is Sole Proprietor?:No
Enumeration Date:2008-02-07
Last Update Date:2019-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME67656207P00000X, 207R00000X
CA146083207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL27640OtherBSBSFL
FL27640OtherBSBSFL