Healthcare Provider Details

I. General information

NPI: 1508445032
Provider Name (Legal Business Name): KENCAR ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/02/2021
Last Update Date: 05/28/2021
Certification Date: 05/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13402 N SCOTTSDALE RD STE A125
SCOTTSDALE AZ
85254-4055
US

IV. Provider business mailing address

4400 N SCOTTSDALE RD STE 805
SCOTTSDALE AZ
85251-3331
US

V. Phone/Fax

Practice location:
  • Phone: 480-530-7575
  • Fax:
Mailing address:
  • Phone: 602-885-4332
  • Fax: 602-865-8171

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. ANN CHERI FOXX LEACH
Title or Position: CO-OWNER
Credential: MD
Phone: 602-885-4332