Individual
DR. ANDREA KAY IRVING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
19251 E OASIS DR, BLACK CANYON CITY, AZ 85324-8878
(623) 374-0200
Mailing address
164 AUGUST LILY CRESCENT, GLOUCESTER, ON K1V 2-E3
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
R1055
AZ
207VG0400X
Gynecology Physician
005207
AZ
208D00000X
General Practice Physician
Primary
005207
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005207
AZ STATE LICENSE NUMBER
AZ
01
—
R1055
TRAINING PERMIT
AZ
Enumeration date
04/18/2008
Last updated
10/12/2021
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