Chavez, Kelly D

Chavez, Kelly D is an individual health care provider with primary practice located at 1729 N Trekell Rd Suite 124, Casa Grande AZ 85222. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Chavez, Kelly D can be contacted via phone (520) 421-7100.

Contact Information

Primary practice address
1729 N Trekell Rd Suite 124 Casa Grande AZ 85222
Phone: (520) 421-7100
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA2004-0001 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA06592 Texas
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 4885 Arizona

Profile Details

NPI number 1356329379
LBN Legal business name Chavez, Kelly D
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2006
Last updated Sep 13th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356329379 NPPES
New Mexico MEDICAID 11435577
New Mexico Other P00990161

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