Provider Demographics
NPI:1770772402
Name:KENNEDY, SCOTT M (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:M
Last Name:KENNEDY
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Gender:M
Credentials:MD
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Mailing Address - Street 1:136 LINDEN DR
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-6900
Mailing Address - Country:US
Mailing Address - Phone:540-678-3588
Mailing Address - Fax:540-678-9025
Practice Address - Street 1:633 SUNSET LN
Practice Address - Street 2:SUITE F
Practice Address - City:CULPEPER
Practice Address - State:VA
Practice Address - Zip Code:22701-3942
Practice Address - Country:US
Practice Address - Phone:540-321-4281
Practice Address - Fax:540-321-4282
Is Sole Proprietor?:No
Enumeration Date:2007-10-18
Last Update Date:2016-12-01
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Provider Licenses
StateLicense IDTaxonomies
VA0101245892207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine