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Shane W Kennedy, MD
Nephrology Physician in Fort Worth, Texas
NPI 1679517569

Shane W Kennedy is a Nephrology Physician based in Fort Worth, TX and is specialized in Nephrology. Shane W Kennedy practices in Fort Worth, TX and has the professional credentials of MD. The NPI Number for Shane W Kennedy is 1679517569 and holds a License No. L6086 (Texas).

The current practice location address for Shane W Kennedy is 2221 8Th Ave, Fort Worth, TX and can be reached out via phone at 817-336-5060 and via fax at 817-336-1744.

Location: 2221 8Th Ave, Fort Worth, TX, 76110-1812
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1679517569
Provider Name
Shane W Kennedy
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
2221 8Th Ave, Fort Worth, TX, 76110-1812
Phone Number
817-336-5060
Fax Number
817-336-1744
Provider Enumeration Date
06/15/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
158632301 05 TX
P00040101 01 MEDICARE RAILROAD
10012357 01 AMERIGROUP
1634611 01 UNISYS
8J5430 01 TX BCBS OF TX
7724474 01 AETNA
institution
Provider Business Practice Location Address Details
Address
2221 8Th Ave
City
Fort Worth
State
Texas
Zip
76110-1812
Phone Number
817-336-5060
Fax Number
817-336-1744
person
Provider Business Mailing Address Details
Address
2221 8Th Ave
City
Fort Worth
State
Texas
Zip
76110-1812
Phone Number
817-336-5060
Fax Number
817-336-1744
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Internal Medicine
Speciality
Nephrology
Taxonomy
207RN0300X
License No.
L6086 (Texas)
Definition
An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation.
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