Perdue, Kevin Dale
Perdue, Kevin Dale is an individual health care provider with primary practice located at 1900 Redrock Dr , Gallup NM 87301-5682. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Perdue, Kevin Dale can be contacted via phone (505) 863-7200.Contact Information
Primary practice address
1900 Redrock Dr
Gallup NM 87301-5682
Phone: (505) 863-7200
Fax: (505) 726-6720
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Orthopaedic Surgery | 207X00000X | MD2006-0520 | New Mexico |
Profile Details
| NPI number | 1679593420 |
|---|---|
| LBN Legal business name | Perdue, Kevin Dale |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 21st, 2006 |
| Last updated | Jul 9th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1679593420 | NPPES |
| Arizona | MEDICAID | 124003 | |
| Arizona | MEDICAID | 56238835 | |
| Arizona | Other | NM001H96 | |
| Arizona | Other | QMYPR0072225 | |
| Arizona | Other | 10027150 |
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