Provider Demographics
NPI:1972546802
Name:KENNEY, RICHARD G (DO)
Entity type:Individual
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First Name:RICHARD
Middle Name:G
Last Name:KENNEY
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Gender:M
Credentials:DO
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Mailing Address - Street 1:2631 CUNNINGHAM AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:JOPLIN
Mailing Address - State:MO
Mailing Address - Zip Code:64804-1543
Mailing Address - Country:US
Mailing Address - Phone:417-627-8967
Mailing Address - Fax:417-627-8951
Practice Address - Street 1:3126 S JACKSON AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:JOPLIN
Practice Address - State:MO
Practice Address - Zip Code:64804-2530
Practice Address - Country:US
Practice Address - Phone:417-627-8700
Practice Address - Fax:417-627-8763
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-14
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MOR3B59207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A65485Medicare UPIN