Healthcare Provider Details

I. General information

NPI: 1538651799
Provider Name (Legal Business Name): MOLLY KUCERA DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2018
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10419 E MCDOWELL MOUNTAIN RANCH RD # A-100
SCOTTSDALE AZ
85255-8697
US

IV. Provider business mailing address

2500 W UTOPIA RD STE 100
PHOENIX AZ
85027-4172
US

V. Phone/Fax

Practice location:
  • Phone: 480-882-7530
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number011854
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: