Kevin P Scully in Tyler - Physician Assistant
Kevin P Scully - NPI 1730199563
Kevin P Scully is a Physician Assistant in Tyler, Texas. Kevin P Scully practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Kevin P Scully is 1730199563. The last update date is 2018-08-17.
Kevin P Scully's current location address is 6210 S Broadway Ave, Tyler, Texas. You can contact this provider via phone number 9035792718 and fax number 9035792793. The mailing address for Kevin P Scully is 6210 S Broadway Ave, Tyler, Texas. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Kevin P Scully |
|---|---|
| Address | 6210 S Broadway Ave, Tyler, Texas |
| Phone Number | 9035792718 |
| Fax Number | 9035792793 |
| Sole Proprietor | N |
| Credentials | PAC |
NPI Number Detail
| NPI Number | 1730199563 |
|---|---|
| Provider Enumeration Date | 2006-08-08 |
| Last Updated Date | 2018-08-17 |
Provider Mailing Address Detail
| Address | 6210 S Broadway Ave |
|---|---|
| City | Tyler |
| State | Texas (TX) |
| Post Code | 757034413 |
| Phone Number | 9035792718 |
| Fax Number | 9035792793 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA03374 |
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Definition: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perfor |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 192484701 | TX | -- | |
| 192484704 | TX | -- |
Post Comment/ Review Below
What is the Kevin P Scully's unique identification number?
The Kevin P Scully has been assigned the NPI (National Provider Identifier) Number 1730199563 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for the organization.
Could you please provide the complete street address where Kevin P Scully is physically located?
The Kevin P Scully is physically situated at the following address: 6210 S Broadway Ave, Tyler, TX, 757034413.
On what date did the Kevin P Scully receive its 1730199563 assignment from the Centers for Medicare & Medicaid Services?
The Kevin P Scully was assigned its 1730199563 by the Centers for Medicare & Medicaid Services on 2006-08-08.
As of what date were the Kevin P Scully's details last updated?
The information pertaining to the Kevin P Scully, including its address, specialty, and other details, was most recently updated on 2018-08-17.
As of what date were the details related to Kevin P Scully most recently updated or revised?
The information pertaining to Kevin P Scully, including its address, specialty, and other relevant details, was last updated or revised on 2018-08-17.
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