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Physician Compare National (NPI:1700914355)

HEALTHCARE PROVIDER: KENDALL DUANE ANDERSON D.C.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information

NPI 1700914355
Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID 3476638206
Unique individual clinician ID assigned by PECOS
Professional Enrollment ID I20080304000571
Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name ANDERSON
Individual professional last name
Provider First Name KENDALL
Individual professional first name
Provider Middle Name D
Individual professional middle name
Provider Gender M
The provider's gender if the provider is a person.

Medical School Information

Medical School Name NORTHWESTERN COLLEGE OF CHIROPRACTIC
Individual professional's medical school
Graduation Year 1986
Individual professional's medical school graduation year
Primary Specialty CHIROPRACTIC
Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information

Line 1 Street Address 3618 CANYON LAKE DR
Group Practice or individual's line 1 address
Line 2 Street Address SUITE 114
Group Practice or individual's line 2 address
City RAPID CITY
Group Practice or individual's city
State SD
Group Practice or individual's state
Zip Code 577023129
Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information

Professional Accepts Medicare Assignment M

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