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General NPI Number Information
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NPI Number | 1245201565
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Entity Type | Individual
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Provider Name | ERIC NORMAN KINN M.D.
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Gender | Male
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Dates
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Enumeration Date | 01/27/2006
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Last Update Date | 10/23/2023
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Provider Practice Location Address
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Address Line | 529 N GALLOWAY AVE SUITE 16
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City | MESQUITE
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State | TX
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Zip | 75149-3420
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Country | US
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Telephone | 972-216-4411
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Fax | 972-216-7346
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Provider Business Mailing Address
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Address Line | 182 BARTLETT DR
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City | PITTSBORO
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State | NC
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Zip | 27312-7516
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Country | US
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Telephone | 940-230-4379
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A65878
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | M6707
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 036-11711
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License Number State | IL
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