Provider Demographics
NPI:1710250030
Name:MCKEOWN, KEVIN M (DO)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:M
Last Name:MCKEOWN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8265 E DEL CADENA DR
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-2326
Mailing Address - Country:US
Mailing Address - Phone:602-421-7495
Mailing Address - Fax:248-967-7794
Practice Address - Street 1:8265 E DEL CADENA DR
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-2326
Practice Address - Country:US
Practice Address - Phone:602-421-7495
Practice Address - Fax:248-967-7794
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-16
Last Update Date:2013-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101018040207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine