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General NPI Number Information
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NPI Number | 1255345336
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Entity Type | Individual
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Provider Name | KIMBERLY S HENDRICKS DO
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Gender | Female
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Dates
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Enumeration Date | 07/27/2006
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 800 WAYNE ST STE 100
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City | MARIETTA
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State | OH
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Zip | 45750-3309
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Country | US
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Telephone | 740-568-2214
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Fax | 740-568-2099
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Provider Business Mailing Address
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Address Line | 7707 PARAGON RD SUITE 101
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City | DAYTON
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State | OH
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Zip | 45459-4041
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Country | US
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Telephone | 937-208-6920
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Fax | 937-208-6920
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 03199
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 34.008678
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License Number State | OH
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