MEDICARE: BRIAN KUMMET PA-C

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	363A00000X	Physician Assistant	6189	AZ

General Provider Information

NPI Number	:	1801266218
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRIAN KUMMET PA-C

Provider Business Mailing Address
First Line	:	4117 N 17TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-5921
Country	:	US
Telephone Number	:	480-440-2886
Fax Number	:	480-781-4524

Provider Business Practice Location Address
First Line	:	4117 N 17TH ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85016-5921
Country	:	US
Telephone Number	:	480-341-5174
Fax Number	:	480-781-4524

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/28/2015
Last Update Date	:	09/12/2025

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Directions to “ BRIAN KUMMET PA-C” Practice Location

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