Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevin Stanley Broaddrick, DPM

Individual provider Podiatrist · NPI 1639188394

Kevin Stanley Broaddrick, DPM is a Podiatrist in Peoria, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2006
What do these letters mean?
DPM — Doctor of Podiatric Medicine
A foot and ankle physician and surgeon.

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Practice location Address checks out

6739 W Cactus Rd
Peoria, AZ 85381-5311
Phone: (833) 242-0100
Fax: (602) 805-4745
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Podiatrist (primary) Taxonomy 213E00000X · Licence POD-000814 (AZ)

Record details

NPI number1639188394
Entity typeIndividual (Type 1)
GenderMale
Credentials DPM
Sole proprietorYes
NPI enumeratedAugust 5, 2006
Last updated in NPPESAugust 11, 2023
Certification dateAugust 11, 2023

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