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General NPI Number Information
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NPI Number | 1841318276
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Entity Type | Individual
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Provider Name | DOUGLAS KENT MCVEY PA-C
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Gender | Male
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Dates
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Enumeration Date | 03/26/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 708 E WYTHE CREEK CT STE 103
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City | KUNA
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State | ID
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Zip | 83634-5005
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Country | US
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Telephone | 208-922-5338
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Fax | 208-922-5340
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Provider Business Mailing Address
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Address Line | 708 E WYTHE CREEK CT STE 103
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City | KUNA
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State | ID
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Zip | 83634-5005
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Country | US
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Telephone | 208-922-5338
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Fax | 208-922-5340
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA-230
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License Number State | ID
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