Healthcare Provider Details

I. General information

NPI: 1447226766
Provider Name (Legal Business Name): ROBERT R KUSKE JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2006
Last Update Date: 01/08/2020
Certification Date: 01/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10460 N 92ND ST STE 101
SCOTTSDALE AZ
85258-4547
US

IV. Provider business mailing address

10460 N 92ND ST STE 101
SCOTTSDALE AZ
85258-4547
US

V. Phone/Fax

Practice location:
  • Phone: 480-922-4600
  • Fax: 480-922-5231
Mailing address:
  • Phone: 480-922-4600
  • Fax: 480-922-5231

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number31944
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: