Kendall Wayne Southern in Vinita - Psychiatry
Kendall Wayne Southern - NPI 1407917792
Kendall Wayne Southern is a Psychiatry in Vinita, Oklahoma. Kendall Wayne Southern practices all healthcare services and medical treatments related to Psychiatry. The NPI Number for Kendall Wayne Southern is 1407917792. The last update date is 2011-10-17.
Kendall Wayne Southern's current location address is Po Box 69, Vinita, Oklahoma. You can contact this provider via phone number 9182613612 and fax number 9182562952. The mailing address for Kendall Wayne Southern is Po Box 69, Vinita, Oklahoma. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kendall Wayne Southern |
|---|---|
| Address | Po Box 69, Vinita, Oklahoma |
| Phone Number | 9182613612 |
| Fax Number | 9182562952 |
| Sole Proprietor | Y |
| Credentials | D.O., D.PH |
NPI Number Detail
| NPI Number | 1407917792 |
|---|---|
| Provider Enumeration Date | 2006-12-12 |
| Last Updated Date | 2011-10-17 |
Provider Mailing Address Detail
| Address | Po Box 69 |
|---|---|
| City | Vinita |
| State | Oklahoma (OK) |
| Post Code | 743010069 |
| Phone Number | 9182613612 |
| Fax Number | 9182562952 |
Provider's Primary Taxonomy Detail
| Speciality | Psychiatry |
|---|---|
| Taxonomy | 2084P0800X |
| Licence No | 2333 |
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Definition: A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 100124360A | OK | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Kendall Wayne Southern by the Centers for Medicare & Medicaid Services?
The Kendall Wayne Southern has been assigned the NPI (National Provider Identifier) 1407917792 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you please share the complete physical address where Kendall Wayne Southern is geographically located?
The Kendall Wayne Southern is physically situated at the following location: Po Box 69, Vinita, OK, 743010069.
What is the area of specialization for Kendall Wayne Southern, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Kendall Wayne Southern is Psychiatry, and the corresponding taxonomy code that categorizes this area of expertise is 2084P0800X.
On what date did the Kendall Wayne Southern receive its 1407917792 assignment from the Centers for Medicare & Medicaid Services?
The Kendall Wayne Southern was assigned its 1407917792 by the Centers for Medicare & Medicaid Services on 2006-12-12.
As of what date were the details pertaining to Kendall Wayne Southern last refreshed?
The information related to the Kendall Wayne Southern, including its address, specialty, and other relevant details, was last updated on 2011-10-17.
NPI Number: 1417950320
Address: 1395 Center Drive, D7-6a, Box 100416, Gainesville, FL