Jason R Kennedy (NPI# 1518151935, PAC ID# 8325103054) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is MAXILLOFACIAL SURGERY.
| Nation Provider ID (NPI) | 1518151935 |
| PAC ID by PECOS | 8325103054 |
| Professional Enrollment ID | I20090212000632 |
| Full Name | Jason R Kennedy |
| Organization Legal Name | SOUTHEAST ORAL SURGERY PC |
| Address |
1858 Crest Rd Maryville TN 37804-4305 |
| Phone Number | 8659777110 |
| Gender | M |
| Graduation Year | 2008 |
| Primary Specialty | MAXILLOFACIAL SURGERY |
| Secondary Specialties | ORAL SURGERY |
| Group Practice PAC ID | 4789628207 |
| Number of Group Practice Members | 4 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 440015 | UNIVERSITY OF TN MEDICAL CENTER |
| Address | Phone | Organization |
|---|---|---|
| 1858 Crest Rd, Maryville, TN 37804-4305 | 8659777110 | SOUTHEAST ORAL SURGERY PC |
| Organization Legal Name | SOUTHEAST ORAL SURGERY PC |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Garren Petree | Oral Surgery | Southeast Oral Surgery PC | 7761 Dannaher Dr, Powell, TN 37849-4049 |
| Troy Randall Napier | Maxillofacial Surgery | Southeast Oral Surgery PC | 1858 Crest Rd, Maryville, TN 37804-4305 |
| Timothy P Mcconnell | Maxillofacial Surgery | Southeast Oral Surgery PC | 1858 Crest Rd, Maryville, TN 37804-4305 |
| Otto W Slater | Maxillofacial Surgery | Southeast Oral Surgery PC | 7761 Dannaher Dr, Powell, TN 37849-4049 |
| Street Address |
1858 CREST RD |
| City | MARYVILLE |
| State | TN |
| Zip | 37804-4305 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Troy Randall Napier | Maxillofacial Surgery | Southeast Oral Surgery PC | 1858 Crest Rd, Maryville, TN 37804-4305 |
| Timothy P Mcconnell | Maxillofacial Surgery | Southeast Oral Surgery PC | 1858 Crest Rd, Maryville, TN 37804-4305 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Mary K Poese | Physician Assistant | Carole L Long Md PC | 2036 Chilhowee, Professional Bldg, Maryville, TN 37804-0001 |
| Paul D Rook | Qualified Audiologist | Blount Hearing and Speech Services, Inc. | 1617 E Broadway, Maryville, TN 37804-2913 |
| Natalie H Mcamis | Qualified Audiologist | Blount Hearing and Speech Services, Inc. | 1617 E Broadway, Maryville, TN 37804-2913 |
| Elisabeth J Galloway | Qualified Audiologist | Blount Hearing and Speech Services, Inc. | 1617 E Broadway, Maryville, TN 37804-2913 |
| Sharon N Chastain | Psychiatry | Helen Ross Mcnabb Center | 1704 E Broadway Ave, Maryville, TN 37804-2916 |
| Tracy Gibson Grabman | Psychiatry | Helen Ross Mcnabb Center | 1704 E Broadway Ave, Maryville, TN 37804-2916 |
| Angela L Obear | Clinical Social Worker | Helen Ross Mcnabb Center | 1704 E Broadway Ave, Maryville, TN 37804-2916 |
| Shannon E Everette | Nurse Practitioner | Blount Senior Care Partners, Pllc | 2648 Sevierville Rd, Maryville, TN 37804-3643 |
| Renee J Hyatt | Internal Medicine | Blount Senior Care Partners, Pllc | 2648 Sevierville Rd, Maryville, TN 37804-3643 |
| Traci C Grime | Nurse Practitioner | Blount Senior Care Partners, Pllc | 2648 Sevierville Rd, Maryville, TN 37804-3643 |
| Find all physicians in zip 37804 | |||
| City | MARYVILLE |
| Zip Code | 37804 |
| Specialty | MAXILLOFACIAL SURGERY |
| City + Specialty | MARYVILLE + MAXILLOFACIAL SURGERY |
Please comment or provide details below to improve the information on Jason R Kennedy.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.