Healthcare Provider Details

I. General information

NPI: 1093797649
Provider Name (Legal Business Name): ROLF KNIGHTS HULTSCH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/18/2005
Last Update Date: 09/09/2021
Certification Date: 09/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3501 N SCOTTSDALE RD SUITE 130
SCOTTSDALE AZ
85251-5648
US

IV. Provider business mailing address

PO BOX 3114
SCOTTSDALE AZ
85271-3114
US

V. Phone/Fax

Practice location:
  • Phone: 480-425-5000
  • Fax: 480-945-6548
Mailing address:
  • Phone: 480-425-5063
  • Fax: 480-425-5010

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number34283
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number34283
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: