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

Mr. Kevin Michael Fordell, PA

Individual provider Physician Assistant · NPI 1417107822

Mr. Kevin Michael Fordell, PA is a Physician Assistant in Mesa, Arizona. Practices as a sole proprietor. Licensed in Arizona.

Licensed in
AZ
In the registry since
2008
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

2550 N Thunderbird Cir Ste 303
Mesa, AZ 85215-1219
Phone: (480) 924-8382
Fax: (480) 924-8399
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 4295 (AZ)
Physician Assistant Taxonomy 363A00000X · Licence 4295 (AZ)

Record details

NPI number1417107822
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorYes
NPI enumeratedSeptember 22, 2008
Last updated in NPPESMarch 1, 2023
Certification dateMarch 1, 2023

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