Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0127X | Trauma Surgeon | 17703 | AZ |
NPI | 1144330408 |
---|---|
Provider Name | Kevin P Mcgeever |
First Address | Phoenix, AZ 85012-2716 |
Second Address | Phoenix, AZ 85013-4224 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 16/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
278251 | AHCCCS NUMBER (01) | AZ |
D44239 | (02) | AZ |