Mahoney, Kevin Robert

Mahoney, Kevin Robert is an individual health care provider with primary practice located at 120 N C Ave , Thermopolis WY 82443-2410. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Emergency Medicine. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Mahoney, Kevin Robert can be contacted via phone (307) 864-5534.

Contact Information

Primary practice address
120 N C Ave Thermopolis WY 82443-2410
Phone: (307) 864-5534
Fax: (307) 864-9470
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 5591AWY Wyoming
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 5591A Wyoming

Profile Details

NPI number 1164494241
LBN Legal business name Mahoney, Kevin Robert
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2006
Last updated Mar 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164494241 NPPES
Wyoming MEDICAID 110846800
Wyoming Other 512KRM98
Wyoming Other 5591AWY

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