Individual
KEVIN DRAKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
485 S DOBSON RD STE 100, CHANDLER, AZ 85224-5603
(602) 406-4000
(602) 406-6498
Mailing address
500 W THOMAS RD STE 500, PHOENIX, AZ 85013-4220
(602) 406-4000
(602) 406-6498
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
6438
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
221608
—
AZ
Enumeration date
09/26/2016
Last updated
05/23/2022
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