Healthcare Provider Details

I. General information

NPI: 1578583928
Provider Name (Legal Business Name): JOHN A KEARNEY JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2006
Last Update Date: 03/26/2025
Certification Date: 03/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10494 W THUNDERBIRD BLVD STE 102
SUN CITY AZ
85351-3058
US

IV. Provider business mailing address

18444 N 25TH AVE STE 310
PHOENIX AZ
85023-1266
US

V. Phone/Fax

Practice location:
  • Phone: 623-537-5600
  • Fax: 866-939-2673
Mailing address:
  • Phone: 623-537-5600
  • Fax: 866-939-2673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number35801
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35801
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: