Keven R Mottinger in Kenosha - Physician Assistant
Keven R Mottinger - NPI 1154377091
Keven R Mottinger is a Physician Assistant in Kenosha, Wisconsin. Keven R Mottinger practices all healthcare services and medical treatments related to Physician Assistant. The NPI Number for Keven R Mottinger is 1154377091. The last update date is 2020-08-31.
Keven R Mottinger's current location address is 4536 22nd Ave, Kenosha, Wisconsin. You can contact this provider via phone number 2626560044 and fax number 2626532218. The mailing address for Keven R Mottinger is 4536 22nd Ave, Kenosha, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Keven R Mottinger |
|---|---|
| Address | 4536 22nd Ave, Kenosha, Wisconsin |
| Phone Number | 2626560044 |
| Fax Number | 2626532218 |
| Sole Proprietor | N |
| Credentials | PAC |
NPI Number Detail
| NPI Number | 1154377091 |
|---|---|
| Provider Enumeration Date | 2006-05-25 |
| Last Updated Date | 2020-08-31 |
Provider Mailing Address Detail
| Address | 4536 22nd Ave |
|---|---|
| City | Kenosha |
| State | Wisconsin (WI) |
| Post Code | 531405917 |
| Phone Number | 2626560044 |
| Fax Number | 2626532218 |
Provider's Primary Taxonomy Detail
| Speciality | Physician Assistant |
|---|---|
| Taxonomy | 363A00000X |
| Licence No | 1868 |
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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 |
|---|---|---|---|
| 12006222 | CAQH |
Post Comment/ Review Below
What is the unique identifier code issued to Keven R Mottinger by the Centers for Medicare & Medicaid Services (CMS)?
The Keven R Mottinger has been assigned the NPI (National Provider Identifier) 1154377091. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Can you provide the Keven R Mottinger's physical address?
The Keven R Mottinger is physically located at 4536 22Nd Ave, in the city of Kenosha, WI, with the postal code 531405917.
What is the Keven R Mottinger's area of specialization and corresponding taxonomy classification?
The Keven R Mottinger's specialty field is Physician Assistant, and it falls under the taxonomy code 363A00000X, which categorizes healthcare providers based on their specialties.
When was the Keven R Mottinger's 1154377091 issued?
The Keven R Mottinger's 1154377091 was issued on 2006-05-25.
When was the information regarding Keven R Mottinger most recently updated?
The details pertaining to the Keven R Mottinger, including its address, specialty, and other relevant information, were last refreshed on 2020-08-31.