Healthcare Provider Details

I. General information

NPI: 1154710572
Provider Name (Legal Business Name): CAMERON RICHARDSON KENDALL M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/22/2015
Last Update Date: 07/11/2026
Certification Date: 07/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 HIGHLAND AVE
MADISON WI
53792-2111
US

IV. Provider business mailing address

620 JOHN PAUL JONES CIR STE 275
PORTSMOUTH VA
23708-2197
US

V. Phone/Fax

Practice location:
  • Phone: 608-263-6400
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number84377-20
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number2017-01101
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: