Organization
WILLIAM F KIVETT MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM F KIVETT MD (OWNER)
(707) 291-5096
Entity
Organization
Contact information
Practice address
1140 SONOMA AVE STE 1A, SANTA ROSA, CA 95405-4817
(707) 275-6410
(707) 275-6075
Mailing address
PO BOX 2196, WINDSOR, CA 95492-2196
(707) 291-5096
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
—
—
207ND0101X
MOHS-Micrographic Surgery Physician
—
—
2082S0105X
Surgery of the Hand (Plastic Surgery) Physician
—
—
2086S0122X
Plastic and Reconstructive Surgery Physician
—
—
Other
Enumeration date
11/12/2020
Last updated
02/05/2021
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