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Individual

RICHARD L KENDALL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
135 W PERRY ST, PORT CLINTON, OH 43452-1010
(419) 732-7800
(419) 797-4843
Mailing address
135 W PERRY ST, PORT CLINTON, OH 43452-1010
(419) 732-7800
(419) 797-4843

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35062349
OH
208D00000X
General Practice Physician
35062349
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0872515
OH
01
4194361
MEDICARE PTAN
OH
01
P00342604
RAILROAD MEDICARE
Enumeration date
07/28/2006
Last updated
10/14/2013
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