Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 02876 | KY |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 008057 | AZ |
N | 207YX0007X | Plastic Surgeon (Head & Neck) | 2012001378 | MO |
NPI | 1194787937 |
---|---|
Provider Name | Daren Gregg Kest |
First Address | Phoenix, AZ 85016-8034 |
Second Address | Phoenix, AZ 85016-8034 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2006 |
Last Update Date | 02/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64029382 | (05) | KY |
H20963 | (02) |