Healthcare Provider Details

I. General information

NPI: 1255773370
Provider Name (Legal Business Name): AKDHC,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2013
Last Update Date: 11/27/2024
Certification Date: 11/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

118 S MOUNTAIN AVE
SPRINGERVILLE AZ
85938-5104
US

IV. Provider business mailing address

3333 E CAMELBACK RD STE 180
PHOENIX AZ
85018-2396
US

V. Phone/Fax

Practice location:
  • Phone: 928-333-4368
  • Fax: 928-333-7157
Mailing address:
  • Phone: 602-759-6883
  • Fax: 602-224-3358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number
License Number StateAZ

VIII. Authorized Official

Name: MS. KRISTEN KLEIN
Title or Position: DIRECTOR OF PHYSICIAN SERVICES
Credential:
Phone: 602-997-0484