DR. KENDALL WAYNE SOUTHERN D.O., D.PH.
NPI 1407917792
Psychiatry & Neurology - Psychiatry in Vinita, OK

Q: What is Kendall Southern's NPI number?

The NPI number for Kendall Southern is 1407917792. It was assigned to this individual provider in the NPPES registry on December 12, 2006.

Q: What is Kendall Southern's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Psychiatry, with taxonomy code 2084P0800X.

Q: When was this NPI record last updated?

The NPPES record for Kendall Southern was last updated on October 17, 2011. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 14 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since December 12, 2006

24800 S 4420 RD, VINITA, OK 74301(918) 256-7841(918) 256-2952 Get Directions Write a Review

NPPES record last updated: October 17, 2011. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Kendall Wayne Southern D.o., D.ph. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. KENDALL WAYNE SOUTHERN D.O., D.PH. (NPI 1407917792) is an individual psychiatry provider in Vinita, Oklahoma, licensed in Oklahoma (2333) and active in the NPI registry since December 2006.

NPPES Registry Identity

NPI1407917792

Entity TypeIndividualMale

Primary Taxonomy2084P0800X

Provider Legal NameDR. KENDALL WAYNE SOUTHERNCredential: D.O., D.PH.

Location Address24800 S 4420 RDVinita, OK 74301

Mailing AddressPo Box 69Vinita, OK 74301-0069 · (918) 261-3612 · Fax (918) 256-2952

Phone(918) 256-7841

Fax(918) 256-2952

Sole ProprietorYes

Enumeration DateDecember 12, 2006

Last NPPES UpdateOctober 17, 2011

✔ NPI 1407917792 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyPsychiatry & Neurology · PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0800X

Licenses✔ Licensed in OK · 2333✔ Licensed in TX · H9426✔ Licensed in AL · DO-641✔ Licensed in GA · 48464✔ Licensed in MI · 5101009836

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 disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.

Also ListedPharmacistTaxonomy 183500000X · License 9440 (OK)

Also ListedFamily MedicineTaxonomy 207Q00000X · License 2333 (OK)

24800 S 4420 RD, Vinita, OK 74301

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Other Identifiers 2

Medicaid100124360AOK

Medicare UPINE09679OK

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. MICHELLE D MOSS PHARMD

Pharmacist