Organization
KEVIN J LYTHGOE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN J LYTHGOE MD (PRESIDENT)
(602) 351-2229
Entity
Organization
Contact information
Practice address
530 E THOMAS RD, PHOENIX, AZ 85012-3204
(602) 351-2229
(602) 351-1500
Mailing address
530 E THOMAS RD, PHOENIX, AZ 85012-3204
(602) 351-2229
(602) 351-1500
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
21855
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
198433
—
AZ
01
—
1Z1309
HEALTH NET
AZ
01
—
3372334
CIGNA
AZ
01
—
4198433
HEALTH CHOICE
AZ
01
—
AZ0860720
BLUE CROSS BLUE SHIELD
AZ
01
—
POB13LYTHKE1
MERCY CARE PLAN
AZ
Enumeration date
08/19/2006
Last updated
12/20/2007
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