Healthcare Provider Details

I. General information

NPI: 1811488505
Provider Name (Legal Business Name): KENDRA BATEY MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2018
Last Update Date: 06/30/2025
Certification Date: 06/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3647 J DEWEY GRAY CIR STE 200
AUGUSTA GA
30909-2205
US

IV. Provider business mailing address

1001 CRYSTAL WAY APT J
DELRAY BEACH FL
33444-1006
US

V. Phone/Fax

Practice location:
  • Phone: 706-504-9712
  • Fax: 706-504-9703
Mailing address:
  • Phone: 615-554-6892
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number104054
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberTRN26518
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: