Healthcare Provider Details

I. General information

NPI: 1740825975
Provider Name (Legal Business Name): NORMAN HEATH KINGTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2019
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8320 W MARINERS WAY
PEORIA AZ
85382-4775
US

IV. Provider business mailing address

PO BOX 861
WELLS NV
89835-0861
US

V. Phone/Fax

Practice location:
  • Phone: 855-772-8847
  • Fax:
Mailing address:
  • Phone: 775-340-3880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-24-77382
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: