Provider Demographics
NPI:1558551218
Name:KENDRICK, AARON SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:AARON
Middle Name:SCOTT
Last Name:KENDRICK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230-0030
Mailing Address - Country:US
Mailing Address - Phone:606-638-1154
Mailing Address - Fax:606-638-4502
Practice Address - Street 1:2483 HIGHWAY 644
Practice Address - Street 2:STE 106
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230-9242
Practice Address - Country:US
Practice Address - Phone:606-638-1154
Practice Address - Fax:606-638-4502
Is Sole Proprietor?:No
Enumeration Date:2007-07-30
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03107207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100099030Medicaid
KYP00988894 RAILROADMedicare PIN
KYK0061200 ANESTHESIAMedicare PIN
KY7100099030Medicaid