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Individual

DR. KENNETH JAMES WESTRATE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
12033 AGENCY RD, PARKER, AZ 85344-7718
(928) 669-2137
(928) 669-3131
Mailing address
1310 CALIMESA CT, LAKE HAVASU CITY, AZ 86406-8045
(616) 855-0526

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301046165
MI
208000000X
Pediatrics Physician
4301046165
MI
208D00000X
General Practice Physician
4301046165
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
717845
AZ
Enumeration date
09/02/2006
Last updated
07/31/2013
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