Provider Demographics
NPI:1417343153
Name:KENDALL, RALPH TALBOT (MD)
Entity Type:Individual
Prefix:DR
First Name:RALPH
Middle Name:TALBOT
Last Name:KENDALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3502 PINE TREE SQ
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80909-6436
Mailing Address - Country:US
Mailing Address - Phone:719-635-9317
Mailing Address - Fax:719-635-2575
Practice Address - Street 1:3502 PINE TREE SQ
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80909-6436
Practice Address - Country:US
Practice Address - Phone:719-635-9317
Practice Address - Fax:719-635-2575
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-09
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODR.0020200207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology