Perdue, Kevin Dale

Perdue, Kevin Dale is an individual health care provider with primary practice located at 1900 Redrock Dr , Gallup NM 87301-5682. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Perdue, Kevin Dale can be contacted via phone (505) 863-7200.

Contact Information

Primary practice address
1900 Redrock Dr Gallup NM 87301-5682
Phone: (505) 863-7200
Fax: (505) 726-6720
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X MD2006-0520 New Mexico

Profile Details

NPI number 1679593420
LBN Legal business name Perdue, Kevin Dale
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 21st, 2006
Last updated Jul 9th, 2007 - about 19 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 1679593420 NPPES
Arizona MEDICAID 124003
Arizona MEDICAID 56238835
Arizona Other NM001H96
Arizona Other QMYPR0072225
Arizona Other 10027150

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