NPI 1023083144

Kevin Earlywine, PAC

Practitioner Physician Assistant San Tan Valley, AZ

Practice location

Address: 40773 N Ironwood Dr, San Tan Valley, AZ 85140-7002
Phone: (602) 714-1271
Fax: (480) 987-6566
Mailing address: 1250 S Clearview Ave STE 100, Mesa, AZ 85209-3378

Registered specialties

Physician Assistant Primary

Physician Assistants & Advanced Practice Nursing Providers Taxonomy 363A00000X Licence 2140 (AZ)

Other Physician Assistant providers in Arizona →

Registry record

NPI: 1023083144
Entity type: Individual
Sex (as registered): Male
NPI issued: 22 Feb 2006
Record last updated: 22 Apr 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.