Dr. Kevin John Haselhorst, MD

General Practice in Goodyear, AZ. Individual provider (NPI-1).

NPI number1831170935

StatusActive

Last updated in NPPESSep 28, 2021

Details

NPI: 1831170935
Entity type: Individual (NPI-1)
Name: Dr. Kevin John Haselhorst
Credential: MD
Sex: Male
Sole proprietor: No
Enumeration date: Nov 7, 2005
Certification date: Sep 28, 2021
Last updated: Sep 28, 2021

Medicare and OIG

Medicare enrolled (PECOS): Yes · PRACTITIONER - EMERGENCY MEDICINE
Can order and refer: Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice Yes
OIG exclusion list: This NPI is not listed

CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
208D00000X	General Practice	25725	AZ	Yes
207P00000X	Emergency Medicine	25725	AZ

Practice location

13677 W McDowell Rd
Goodyear, AZ 85338-2618

Phone 623-882-1500

Mailing address

5777 N 78th Pl
Scottsdale, AZ 85250-6170

Phone 480-947-9682

Is something wrong?

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Other General Practice Physician providers in Goodyear, AZ

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