Individual
KELLY J HENDRICKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
04-30708
KS
207XS0114X
Adult Reconstructive Orthopaedic Surgery Physician
Primary
04-30708
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200265840A
—
KS
05
—
209281302
—
MO
01
—
34266011
BCBS
MO
01
—
580580
FIRSTGUARD
KS
01
—
P00154501
RAILROAD MEDICARE
—
Enumeration date
08/30/2006
Last updated
01/27/2022
Update your record
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