Provider Demographics
NPI:1952382798
Name:KENDRICK, DAVID CARLAN (MD MPH)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CARLAN
Last Name:KENDRICK
Suffix:
Gender:M
Credentials:MD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 268838
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73126-8838
Mailing Address - Country:US
Mailing Address - Phone:918-660-3095
Mailing Address - Fax:918-660-3090
Practice Address - Street 1:4444 E 41ST ST
Practice Address - Street 2:3RD FLOOR, STE A
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74135-2527
Practice Address - Country:US
Practice Address - Phone:918-660-3095
Practice Address - Fax:918-660-3090
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK22120207R00000X, 208000000X, 2083C0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2083C0008XAllopathic & Osteopathic PhysiciansPreventive MedicineClinical Informatics
Provider Identifiers
StateIdentifier IDID TypeIssuer
I39820Medicare UPIN