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Individual

ROBERT SCOTT KINKADE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M .D.

Contact information

Practice address
651 W MINGUS AVE, SUITE 1D, COTTONWOOD, AZ 86326-4006
(928) 649-1000
(928) 649-3929
Mailing address
651 W. MINGUS AVE, STE 1D, COTTONWOOD, AZ 86326
(928) 649-1000
(928) 649-3929

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
26410
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
020046038
RAILROAD MEDICARE ID NUMB
AZ
05
442153
AZ
01
AZ0863930
BCBS ID NUMBER
AZ
Enumeration date
07/03/2006
Last updated
07/09/2007
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