Leroy Keith Vandyke in Moses Lake - Physician Assistant
Leroy Keith Vandyke - NPI 1306842307
Leroy Keith Vandyke is a Physician Assistant in Moses Lake, Washington. Leroy Keith Vandyke practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Leroy Keith Vandyke is 1306842307. The last update date is 2012-11-30.
Leroy Keith Vandyke's current location address is 3322 Road N Ne, Moses Lake, Washington. You can contact this provider via phone number 5097668555 and fax number 5097668585. The mailing address for Leroy Keith Vandyke is 3322 Road N Ne, Moses Lake, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Leroy Keith Vandyke |
|---|---|
| Address | 3322 Road N Ne, Moses Lake, Washington |
| Phone Number | 5097668555 |
| Fax Number | 5097668585 |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1306842307 |
|---|---|
| Provider Enumeration Date | 2005-06-23 |
| Last Updated Date | 2012-11-30 |
Provider Mailing Address Detail
| Address | 3322 Road N Ne |
|---|---|
| City | Moses Lake |
| State | Washington (WA) |
| Post Code | 988379505 |
| Phone Number | 5097668555 |
| Fax Number | 5097668585 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | PA10003296 |
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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 |
|---|---|---|---|
| 8421323 | WA | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Leroy Keith Vandyke by the Centers for Medicare & Medicaid Services (CMS)?
The Leroy Keith Vandyke has been assigned the NPI (National Provider Identifier) 1306842307. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you provide the complete address where Leroy Keith Vandyke is physically located?
The Leroy Keith Vandyke is situated at the following address: 3322 Road N Ne, Moses Lake, WA 988379505.
What is Leroy Keith Vandyke's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Leroy Keith Vandyke is Physician Assistant, and the taxonomy code that classifies this field of practice is 363A00000X.
When did the Leroy Keith Vandyke receive its 1306842307?
The Leroy Keith Vandyke was issued its 1306842307 on 2005-06-23, which is the date when the organization was assigned this unique identifier.
When was the information regarding Leroy Keith Vandyke most recently updated?
The details pertaining to the Leroy Keith Vandyke, including its address, specialty, and other relevant information, were last refreshed on 2012-11-30.
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