Provider Demographics
NPI:1316945892
Name:KENNEDY, WILLIAM KLUGH (PHARMD, BCPP)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:KLUGH
Last Name:KENNEDY
Suffix:
Gender:M
Credentials:PHARMD, BCPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 LAGOON VIEW XING
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31410-2648
Mailing Address - Country:US
Mailing Address - Phone:912-897-3619
Mailing Address - Fax:912-350-5879
Practice Address - Street 1:105 LAGOON VIEW XING
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31410-2648
Practice Address - Country:US
Practice Address - Phone:912-897-3619
Practice Address - Fax:912-350-5879
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA14793183500000X, 1835N1003X, 1835P1200X, 1835P1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered183500000XPharmacy Service ProvidersPharmacist
Not Answered1835N1003XPharmacy Service ProvidersPharmacistNutrition Support
Not Answered1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Not Answered1835P1300XPharmacy Service ProvidersPharmacistPsychiatric