Healthcare Provider Details

I. General information

NPI: 1881658300
Provider Name (Legal Business Name): FRANCES DOUGHERTY KENDALL MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: FRANCES ELIZABETH DOUGHERTY MD

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 02/16/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1875 OLD ALABAMA RD STE 220
ROSWELL GA
30076-2272
US

IV. Provider business mailing address

5579 CHAMBLEE DUNWOODY RD STE 110
ATLANTA GA
30338-4128
US

V. Phone/Fax

Practice location:
  • Phone: 404-793-7800
  • Fax: 866-744-5665
Mailing address:
  • Phone: 404-793-7800
  • Fax: 866-744-5665

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License Number044706
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207SG0202X
TaxonomyClinical Biochemical Genetics Physician
License Number044706
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: