Individual
DR. TIMOTHY KAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10200 N 92ND ST STE 225, SCOTTSDALE, AZ 85258-4536
(480) 697-4824
(480) 697-4825
Mailing address
10200 N 92ND ST STE 225, SCOTTSDALE, AZ 85258-4536
(480) 697-4824
(480) 697-4825
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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