Individual
MICHAEL DEBOER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Contact information
Practice address
3269 N STOCKTON HILL RD, KINGMAN, AZ 86409-3619
(702) 222-4307
Mailing address
6980 MOUNTAIN MOSS DR, LAS VEGAS, NV 89147-3815
(702) 222-4307
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
007293
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2014
Last updated
01/08/2020
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