# KAYE A CUNNINGHAM MD PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1053421057
- **Authorized official:** DR. KAYE AVARANN CUNNINGHAM MD PC (ATTENDING PHYSICIAN)
- **Authorized official phone:** (928) 768-2558

## Contact information

- **Practice address:** 5653 HWY 95, SUITE A, FORT MOHAVE, AZ 86426
- **Practice address phone:** (928) 768-2558
- **Practice address fax:** (928) 788-2039
- **Mailing address:** PO BOX 8368, FORT MOHAVE, AZ 86427
- **Mailing address phone:** (928) 768-2558
- **Mailing address fax:** (928) 788-2039

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | A71438 | CA | — |
| 207Q00000X | Family Medicine Physician | Z8326 | AZ | Yes |

## Other

- **Enumeration date:** 08/30/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 27112533 | — | CA |
| 05 | — | 514704 | — | AZ |