Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KEVIN BOUDINOT
Active Sole ProprietorKEVIN BOUDINOT is a 2279C0205X healthcare provider located in FORT DEFIANCE, Arizona. NPI 1003549304 is currently active in the NPPES registry. Verify at CMS.
2279C0205X · FORT DEFIANCE, AZ
Registration Details
- NPI Number
- 1003549304
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jul 5, 2022 (4.0689549837437 yrs)
- Last Updated
- Jul 5, 2022
- License
-
044405 (AZ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
CORNER OF ROUTES N12 & N7FORT DEFIANCE, AZ, 86504Browse AZ providers · Browse ZIP 86504
- Phone
- 9287298000
- Primary Specialty
-
2279C0205X
2279C0205X
Other 2279C0205X Providers in FORT DEFIANCE, AZ
| Name | Credential | NPI |
|---|---|---|
| MRS. TRISHA ANN WILLIAMS | RRT | 1902234461 |
| MARK WAYNNE PAULETICH | RRT | 1659957058 |
| JERMAL JACKSON | RRT | 1760115992 |
| ZIA HAIDER | — | 1821701244 |
| JAMES CLIPPINGER II | RRT | 1538848486 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.