Kennett Pediatrics and Asolescents Medicine LLC

NPI #1629511415 in Kennett, Missouri

Provider Information

NPI Number: 1629511415
Entity Type: Organization
Organization Name: Kennett Pediatrics and Asolescents Medicine LLC
Primary Specialty: Family Medicine
Enumeration Date: Nov 28, 2016
Last Updated: Nov 28, 2016

Practice Location

Address: 211 TEACO RD
City: Kennett
State: Missouri
ZIP Code: 63857-3236
Phone: (573) 888-0001

Authorized Official

Name: AMELIA D LEDBETTER
Title: DIRECTOR OF OPERATIONS
Phone: (573) 335-4715

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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