Male or Other

Paul R. Kennedy OD

Optometrist in Lansing, MI(View on Map)

Full Name

Paul R Kennedy OD

NPI Number

1013063114

NPI Type

Individual Provider

Gender

Male

Enumeration Date

01/25/2007

Specialties

(Taxonomies)

Code

152W00000X

Primary Taxonomy

Yes

Licenses

State

Michigan

License Number

4901003763

Contact
Information

Purpose

Mailing
Location

Address

PO BOX 208177
2117 E GRAND RIVER AVE

City

Dallas
Lansing

State

TX
MI

Postal Code

75320-8177
48912-3231

Country

US
US

Telephone Number

(636) 200-4393
(517) 485-2213

Identifiers

Identifier

944801636

Identifier State

MI

Identifier Issuer

Unknown

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 01/18/2021

Provider Address

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