Individual
DR. KENDALL RYAN PUCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22266 HIGHWAY 25, COLUMBIANA, AL 35051-8618
(205) 669-3138
(205) 669-8718
Mailing address
22266 HIGHWAY 25, COLUMBIANA, AL 35051-8618
(205) 669-3138
(205) 669-8718
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
20170
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9933273
—
AL
Enumeration date
06/06/2006
Last updated
07/08/2007
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