Kavanagh, Michael P

Kavanagh, Michael P is an individual health care provider with primary practice located at 6600 Van Aalst Blvd , Fort Benning GA 31905-2102. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist is his primary health care specialty. Kavanagh, Michael P can be contacted via phone (762) 408-1467.

Contact Information

Primary practice address
6600 Van Aalst Blvd Fort Benning GA 31905-2102
Phone: (762) 408-1467
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist 224P00000X 34 Georgia
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist 222Z00000X 34 Georgia

Profile Details

NPI number 1619032497
LBN Legal business name Kavanagh, Michael P
Credentials CPO
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 22nd, 2006
Last updated Sep 17th, 2019 - about 6 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 1619032497 NPPES
Georgia MEDICAID 836804665A

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