Individual
DR. KEVIN SANVILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1415 S HWY 89, JACKSON, WY 83001-8515
(307) 739-8999
(307) 739-9222
Mailing address
PO BOX 428, JACKSON, WY 83001-0428
(307) 739-8999
(307) 739-4811
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
056477
GA
207Q00000X
Family Medicine Physician
Primary
11838A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150685400
—
WY
Enumeration date
02/05/2008
Last updated
02/18/2021
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