Provider Demographics
NPI:1881631182
Name:QUINN, WILLIAM KEVIN (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:KEVIN
Last Name:QUINN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4626 E SHEA BLVD
Mailing Address - Street 2:C100
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85028-3071
Mailing Address - Country:US
Mailing Address - Phone:602-996-0190
Mailing Address - Fax:602-996-5516
Practice Address - Street 1:4626 E SHEA BLVD
Practice Address - Street 2:C100
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85028-3071
Practice Address - Country:US
Practice Address - Phone:602-996-0190
Practice Address - Fax:602-996-5516
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10556208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics