Individual
KENDRICK C DAVIDSON
Active
Individual
KENDRICK C DAVIDSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
04-11028
KS
2085R0202X
Diagnostic Radiology Physician
Primary
R3061
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04778143
BCBS KANSAS CITY
MO
05
—
200317850A
—
KS
05
—
203727763
—
MO
01
—
306444
FIRSTGUARD
KS
Enumeration date
10/18/2006
Last updated
05/06/2011
Update your record
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