Provider Demographics
NPI:1407815798
Name:REXROAD, KEVIN E (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:E
Last Name:REXROAD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:PO BOX 4159
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87196-4159
Mailing Address - Country:US
Mailing Address - Phone:505-255-4701
Mailing Address - Fax:505-255-4717
Practice Address - Street 1:3214 PURDUE PL NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2124
Practice Address - Country:US
Practice Address - Phone:505-255-4701
Practice Address - Fax:505-255-4717
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2022-07-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMNM 2002-01522084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry