Individual
MICHAEL J CAVANAUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
CORNER OF ROUTE N12 AND N7, FORT DEFIANCE, AZ 86504
(928) 729-8000
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(928) 729-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
11810
MN
363A00000X
Physician Assistant
Primary
PA.0004654
CO
Other
Enumeration date
01/12/2015
Last updated
03/20/2026
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