Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Wyatt Randolph Eddy, MS, MMS, PA-C

Individual provider Medical Physician Assistant · NPI 1285016394

Mr. Wyatt Randolph Eddy, MS, MMS, PA-C is a Medical Physician Assistant in Kingman, Arizona. Licensed in Arizona. Registered with an NPI since 2015.

Licensed in
AZ
In the registry since
2015
What do these letters mean?
MS — Master of Science
A graduate science degree.
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

3269 Stockton Hill Rd
Kingman, AZ 86409-3619
Phone: (928) 757-2101
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence 6055 (AZ)

Record details

NPI number1285016394
Entity typeIndividual (Type 1)
GenderMale
Credentials MS , MMS , PA-C
Sole proprietorNo
NPI enumeratedJune 25, 2015
Last updated in NPPESDecember 23, 2020
Certification dateDecember 23, 2020

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