Provider Demographics
NPI:1922250612
Name:ARKAWI, KENAN (PA-C)
Entity Type:Individual
Prefix:
First Name:KENAN
Middle Name:
Last Name:ARKAWI
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2285 CORPORATE CIR
Mailing Address - Street 2:STE 200
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89074-7759
Mailing Address - Country:US
Mailing Address - Phone:702-360-2763
Mailing Address - Fax:949-783-2880
Practice Address - Street 1:3102 E INDIAN SCHOOL RD STE 140
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-6872
Practice Address - Country:US
Practice Address - Phone:602-266-0266
Practice Address - Fax:602-266-9757
Is Sole Proprietor?:No
Enumeration Date:2008-10-14
Last Update Date:2018-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ552237Medicaid
AZP00946415OtherRR MEDICARE