Provider Demographics
NPI:1235207424
Name:CHEEVES, KATHERINE J (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:J
Last Name:CHEEVES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:141 S MCCORMICK ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PRESCOTT
Mailing Address - State:AZ
Mailing Address - Zip Code:86303-4731
Mailing Address - Country:US
Mailing Address - Phone:928-445-8400
Mailing Address - Fax:928-776-0208
Practice Address - Street 1:141 S MCCORMICK ST STE 200
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86303-4731
Practice Address - Country:US
Practice Address - Phone:928-445-8400
Practice Address - Fax:928-776-0208
Is Sole Proprietor?:No
Enumeration Date:2006-12-04
Last Update Date:2010-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ209292084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ119893Medicaid
68254Medicare ID - Type Unspecified
AZ119893Medicaid