Individual provider · Type 1 NPI

Wyatt Randolph Eddy, MS, MMS, PA-C

Medical Physician Assistant · Kingman, AZ

NPI number 1285016394 Active

Practice location

3269 Stockton Hill Rd
Kingman, AZ 86409-3619

Mailing address

3269 N Stockton Hill Rd
Kingman, AZ 86409-3619

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700X6055 (AZ)

Medical Physician Assistant: Definition to come...

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About NPI 1285016394

Wyatt Randolph Eddy, MS, MMS, PA-C's National Provider Identifier is 1285016394, issued on Jun 25, 2015. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Kingman, AZ. The record was last updated on Dec 23, 2020.