| Kingman Family Practice, P.c. | |
|
2812 Silver Creek Rd Bullhead City AZ 86442-8309 | |
| (928) 763-1404 | |
| (928) 763-9795 |
| Full Name | Kingman Family Practice, P.c. |
|---|---|
| Speciality | Family Medicine |
| Location | 2812 Silver Creek Rd, Bullhead City, Arizona |
| Authorized Official Name and Position | Kevin Frank Brown (PHYSICIAN) |
| Authorized Official Contact | 9285297744 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingman Family Practice, P.c. 3880 N Stockton Hill Rd Ste 103135 Kingman AZ 86409-0595 Ph: (928) 529-7744 | Kingman Family Practice, P.c. 2812 Silver Creek Rd Bullhead City AZ 86442-8309 Ph: (928) 763-1404 |
| NPI Number | 1346386174 |
|---|---|
| Provider Enumeration Date | 01/29/2007 |
| Last Update Date | 08/24/2019 |
| Medicare PECOS PAC ID | 3577655117 |
|---|---|
| Medicare Enrollment ID | O20070827000839 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346386174 | NPI | - | NPPES |
| 185299 | Medicaid | AZ | |
| DG2348 | Other | AZ | RAILROAD MEDICARE |
| Z116536 | Other | AZ | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 4550 (Arizona) | Primary |
| Provider Name | Kevin Frank Brown |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1245233980 PECOS PAC ID: 9537060637 Enrollment ID: I20070328000366 |
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