Provider Demographics
NPI:1760598999
Name:KENDRICK, F. DONOVAN (MD)
Entity Type:Individual
Prefix:
First Name:F.
Middle Name:DONOVAN
Last Name:KENDRICK
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 1:301 BROWN SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:AL
Mailing Address - Zip Code:36117-7005
Mailing Address - Country:US
Mailing Address - Phone:334-747-4159
Mailing Address - Fax:
Practice Address - Street 1:2065 E SOUTH BLVD STE 204
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:AL
Practice Address - Zip Code:36116-2460
Practice Address - Country:US
Practice Address - Phone:334-747-7300
Practice Address - Fax:334-747-7320
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207T00000X207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000026793KENMedicaid
ALD62588Medicare UPIN
AL000026793Medicare ID - Type UnspecifiedPROVIDER NUMBER