Individual
DR. TIMOTHY KAVANAUGH
Active
Individual
DR. TIMOTHY KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
4942
AK
207X00000X
Orthopaedic Surgery Physician
Primary
58251
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
997601
—
AZ
01
—
Z228811
MEDICARE
AZ
Enumeration date
08/26/2005
Last updated
11/21/2022
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