Doctor Name: | MR. PAUL ERIK KERCKHOFF |
NPI Number: | 1790919777 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | AIR FORCE IDMT |
License Number: | B0441656 |
Business Practice Address: | 701 Hospital Loop Fairchild Afb, WA - 990118704 |
Business Phone Number: | 5092475755 |
Business Fax Number: | 5092478833 |
Mailing Address: | 5998 Kamiakin Trl, FAIRCHILD AFB |
State: | WA |
Postal Code: | 990112210 |
Phone Number: | 5092906206 |
Fax Number: | |
NPI Enumeration Date: | 05/06/2009 |
NPI Last Update Date: | 05/06/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 247200000X |
License Number: | B0441656 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Technologists, Technicians & Other Technical Service Providers |
Taxonomy Classification: | Technician, Other |
Taxonomy Specialization: | |
Taxonomy Definition: | A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user. |