Individual
ARCHIE M KINNEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
200 WEST HOSPITAL DRIVE, WHITERIVER, AZ 85941-0860
(928) 338-4911
(928) 338-1122
Mailing address
PO BOX 860, WHITERIVER INDIAN HOSPITAL, WHITERIVER, AZ 85941-0860
(928) 338-4911
(928) 338-1122
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1148
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427335140
—
AZ
05
—
1427335181
—
AZ
05
—
698821
—
AZ
01
—
970030184
RAILROAD
AZ
Enumeration date
10/24/2005
Last updated
03/19/2013
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