Provider Demographics
NPI:1316165327
Name:KINCADE, NORMAN ALAN
Entity type:Individual
Prefix:MR
First Name:NORMAN
Middle Name:ALAN
Last Name:KINCADE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2461 E REMINGTON PL
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-1525
Mailing Address - Country:US
Mailing Address - Phone:480-786-9144
Mailing Address - Fax:480-786-9144
Practice Address - Street 1:2461 E REMINGTON PL
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-1525
Practice Address - Country:US
Practice Address - Phone:480-786-9144
Practice Address - Fax:480-786-9144
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ8990171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor