IndividualActive
Elaine Kennedy, M.D.
NPI 1083634935 · Pediatric Adolescent Medicine Physician · Tahlequah, OK
Provider details
- NPI number
- 1083634935
- Entity type
- Individual
- Primary specialty
- Pediatric Adolescent Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Female
- Sole proprietor
- No
- License
- 22124 (WV)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
100 S Bliss Ave
Pediatrics Clinic
Tahlequah, OK 74464-2512
Phone: (918) 458-3120
Approximate (ZIP-level) locationGet directions
Mailing address
1390 Heritage Ln
Tahlequah, OK 74464-2136
Registry dates
- Enumerated
- 2006-07-20
- Last updated
- 2011-01-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.