Individual
KATHLEEN A. CAHOON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
2920 N 4TH ST, FLAGSTAFF, AZ 86004-1816
(928) 213-6100
(928) 774-4808
Mailing address
PO BOX 3630, FLAGSTAFF, AZ 86003-3630
(928) 233-5110
(928) 774-6687
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2001684
IN
207Q00000X
Family Medicine Physician
Primary
4279
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000183520
ANTHEM
—
01
—
10780767
CAQH
—
05
—
200051890A
—
IN
05
—
705608
—
AZ
Enumeration date
11/07/2005
Last updated
10/07/2015
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