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NPI Code Detail

MEDICARE: DR. ANDREA KAY IRVING D.O.

MEDICARE: DR. ANDREA KAY IRVING D.O.
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
1207V00000XObstetrics & Gynecology PhysicianR1055AZ
2207VG0400XGynecology Physician005207AZ
3208D00000XGeneral Practice Physician005207AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1005207OTHERAZAZ STATE LICENSE NUMBER
2R1055OTHERAZTRAINING PERMIT

General Provider Information

NPI Number : 1780858878
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANDREA KAY IRVING D.O.
Provider Business Mailing Address
First Line : 164 AUGUST LILY CRESCENT
Second Line :
City : GLOUCESTER
State : ON
Zip : K1V 2E3
Country : CA
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 19251 E OASIS DR
Second Line :
City : BLACK CANYON CITY
State : AZ
Zip : 85324-8878
Country : US
Telephone Number : 623-374-0200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2008
Last Update Date : 10/12/2021

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