NPI 1417985631

Timothy J Kennedy, MD

Practitioner Urology Physician Green Bay, WI

Practice location

Address: 2845 Greenbrier Rd STE 240, Green Bay, WI 54311-6519
Phone: (920) 288-8280
Fax: (920) 288-8285
Mailing address: 2034 Shady Ln, Green Bay, WI 54313-9313

Registered specialties

Urology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208800000X Licence 29987 (WI)

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Registry record

NPI: 1417985631
Entity type: Individual
Sex (as registered): Male
NPI issued: 28 Jun 2006
Record last updated: 1 Jun 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.