Sanville, Kevin

Sanville, Kevin is an individual health care provider with primary practice located at 1415 S Hwy 89 , Jackson WY 83001-8515. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Sanville, Kevin can be contacted via phone (307) 739-8999.

Contact Information

Primary practice address
1415 S Hwy 89 Jackson WY 83001-8515
Phone: (307) 739-8999
Fax: (307) 739-9222
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 056477 Georgia
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 11838A Wyoming

Profile Details

NPI number 1134307911
LBN Legal business name Sanville, Kevin
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 5th, 2008
Last updated Feb 18th, 2021 - about 4 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 1134307911 NPPES
Wyoming MEDICAID 150685400

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