MEDICARE: AKDHC, LL

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RN0300X	Nephrology Physician

General Provider Information

NPI Number	:	1699950485
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AKDHC, LL

Provider Business Mailing Address
First Line	:	3333 E CAMELBACK RD # 108
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-2322
Country	:	US
Telephone Number	:	602-759-6883
Fax Number	:	602-224-3358

Provider Business Practice Location Address
First Line	:	122 E MAIN ST
Second Line	:	AKDHC (MOUNTAIN VIEW FAMILY CLINIC)
City	:	PAYSON
State	:	AZ
Zip	:	85541-0000
Country	:	US
Telephone Number	:	928-474-2888
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF PHYSICIAN SERVICES
Name	:	MS. KRISTEN KLEIN
Credential	:
Telephone Number	:	602-997-0484

Provider Enumeration Date	:	12/31/2007
Last Update Date	:	11/27/2024

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