Healthcare Provider Details

I. General information

NPI: 1376836510
Provider Name (Legal Business Name): JULIA KENDRICK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JULIA KENDRICK M.D.

II. Dates (important events)

Enumeration Date: 05/20/2011
Last Update Date: 02/01/2025
Certification Date: 02/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15790 PAUL VEGA MD DR
HAMMOND LA
70403-1436
US

IV. Provider business mailing address

15790 PAUL VEGA MD DR
HAMMOND LA
70403-1436
US

V. Phone/Fax

Practice location:
  • Phone: 985-230-1683
  • Fax: 985-230-6652
Mailing address:
  • Phone: 985-230-1683
  • Fax: 985-230-6652

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number84071
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number303689
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number137230
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number253445
License Number StateMA
# 5
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number261386
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: