Kevin Stanley Broaddrick in Peoria - Podiatrist
Kevin Stanley Broaddrick - NPI 1639188394
Kevin Stanley Broaddrick is a Podiatrist in Peoria, Arizona. Kevin Stanley Broaddrick practices all healthcare services and medical treatments related to Podiatrist. The NPI Number for Kevin Stanley Broaddrick is 1639188394. The last update date is 2023-08-11.
Kevin Stanley Broaddrick's current location address is 6739 W Cactus Rd, Peoria, Arizona. You can contact this provider via phone number 8332420100 and fax number 6028054745. The mailing address for Kevin Stanley Broaddrick is 6739 W Cactus Rd, Peoria, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin Stanley Broaddrick |
|---|---|
| Address | 6739 W Cactus Rd, Peoria, Arizona |
| Phone Number | 8332420100 |
| Fax Number | 6028054745 |
| Sole Proprietor | Y |
| Credentials | DPM |
NPI Number Detail
| NPI Number | 1639188394 |
|---|---|
| Provider Enumeration Date | 2006-08-05 |
| Last Updated Date | 2023-08-11 |
Provider Mailing Address Detail
| Address | 6739 W Cactus Rd |
|---|---|
| City | Peoria |
| State | Arizona (AZ) |
| Post Code | 853815311 |
| Phone Number | 8332420100 |
| Fax Number | 6028054745 |
Provider's Primary Taxonomy Detail
| Speciality | Podiatrist |
|---|---|
| Taxonomy | 213E00000X |
| Licence No | POD-000814 |
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Definition: A podiatrist is a person qualified by a Doctor of Podiatric Medicine (D.P.M.) degree, licensed by the state, and practicing within the scope of that license. Podiatrists diagnose and treat foot diseases and deformities. They perform medical, surgical |
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Post Comment/ Review Below
What is the unique identifier code issued to Kevin Stanley Broaddrick by the Centers for Medicare & Medicaid Services (CMS)?
The Kevin Stanley Broaddrick has been assigned the NPI (National Provider Identifier) 1639188394. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete address where Kevin Stanley Broaddrick is physically located?
The Kevin Stanley Broaddrick is situated at the following address: 6739 W Cactus Rd, Peoria, AZ 853815311.
What is the Kevin Stanley Broaddrick's area of specialization and corresponding taxonomy classification?
The Kevin Stanley Broaddrick's specialty field is Podiatrist, and it falls under the taxonomy code 213E00000X, which categorizes healthcare providers based on their specialties.
On what date did Kevin Stanley Broaddrick receive its 1639188394 assignment from the Centers for Medicare & Medicaid Services?
The Kevin Stanley Broaddrick was assigned its 1639188394 on 2006-08-05, which is the date when this unique identifier was issued to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details pertaining to Kevin Stanley Broaddrick last refreshed?
The information related to the Kevin Stanley Broaddrick, including its address, specialty, and other relevant details, was last updated on 2023-08-11.