Individual
KEVIN W. CLEARY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7725 N 43RD AVE STE 720, PHOENIX, AZ 85051-5772
(623) 207-5465
(623) 207-5405
Mailing address
7725 N 43RD AVE, STE 720, PHOENIX, AZ 85051-5772
(623) 207-5465
(623) 207-5405
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1647
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
241026
—
AZ
Enumeration date
05/11/2006
Last updated
10/09/2020
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