Provider Demographics
NPI:1124523246
Name:KENDALL, JAMILA AYANA (MD)
Entity type:Individual
Prefix:DR
First Name:JAMILA
Middle Name:AYANA
Last Name:KENDALL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 N PARK TRL STE 100
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-6509
Mailing Address - Country:US
Mailing Address - Phone:770-506-1800
Mailing Address - Fax:
Practice Address - Street 1:2340 PATRICK HENRY PKWY STE 150
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-4326
Practice Address - Country:US
Practice Address - Phone:678-866-3646
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-29
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA92288208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation