DR. KENDALL RYAN PUCKETT M.D. NPI 1174562813

NPI Information

  • NPI: 1174562813
  • Provider Name: DR. KENDALL RYAN PUCKETT, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • Address: 22266 HIGHWAY 25
    COLUMBIANA, AL
    ZIP 35051
  • Phone: (205) 669-3138

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NPI Details

DR. Kendall Ryan Puckett, M.D. is a family medicine in Columbiana, AL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Kendall Ryan Puckett, M.D. NPI is 1174562813. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

22266 HIGHWAY 25
COLUMBIANA, AL
ZIP 35051-618
Phone: (205) 669-3138
Fax: (205) 669-8718

The enumeration date for this NPI number is 6/6/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine20170ALABAMAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G70777MEDICARE UPINALABAMA
251554877MEDICARE ID-TYPE UNSPECIFIEDALABAMA
39933273MEDICAIDALABAMA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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