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NPI Code Detail

MEDICARE: KENDALL K WHITT

MEDICARE: KENDALL K WHITT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1770447930
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENDALL K WHITT
Provider Business Mailing Address
First Line : 486 HAMMERSTEIN RD LOT 74
Second Line :
City : WHEELERSBURG
State : OH
Zip : 45694-8430
Country : US
Telephone Number : 740-876-8290
Fax Number : 740-529-1205
Provider Business Practice Location Address
First Line : 729 6TH ST
Second Line :
City : PORTSMOUTH
State : OH
Zip : 45662-4030
Country : US
Telephone Number : 740-876-8290
Fax Number : 740-529-1205
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/12/2025
Last Update Date : 12/12/2025

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Directions to “ KENDALL K WHITT ” Practice Location

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