Individual
REECE KIRBY HADLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
606 N MAIN ST, EAGAR, AZ 85925-9813
(928) 333-5333
(928) 333-5100
Mailing address
606 N MAIN ST, EAGAR, AZ 85925-9813
(928) 333-5333
(928) 333-5100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5006
AZ
363A00000X
Physician Assistant
PA1252
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
657569
—
AZ
Enumeration date
03/22/2011
Last updated
01/12/2012
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