MEDICARE: MATTHEW KENT ESSARY DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	3646	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1780654715
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW KENT ESSARY DO

Provider Business Mailing Address
First Line	:	2510 W DUNLAP AVE
Second Line	:	SUITE 290
City	:	PHOENIX
State	:	AZ
Zip	:	85021-2737
Country	:	US
Telephone Number	:	602-789-0344
Fax Number	:	602-789-8279

Provider Business Practice Location Address
First Line	:	2510 W DUNLAP AVE
Second Line	:	SUITE 290
City	:	PHOENIX
State	:	AZ
Zip	:	85021-2737
Country	:	US
Telephone Number	:	602-789-0344
Fax Number	:	602-789-8279

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/24/2006
Last Update Date	:	06/20/2017

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Directions to “ MATTHEW KENT ESSARY DO” Practice Location

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