Healthcare Provider Details

I. General information

NPI: 1164438859
Provider Name (Legal Business Name): KENDRA SUE HALL-FRANKS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: KENDRA S. HALL D.O.

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 12/03/2021
Certification Date: 12/03/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3470 LAKELAND HILLS BLVD
LAKELAND FL
33805-1946
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 863-682-0027
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS7976
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License Number02006534A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberOS7976
License Number StateFL
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number0S7976
License Number StateFL
# 5
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number02006534A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: