Healthcare Provider Details

I. General information

NPI: 1235168329
Provider Name (Legal Business Name): KAREN L LEBER, MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/01/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 E SOUTHERN AVE
TEMPE AZ
85282-7610
US

IV. Provider business mailing address

2600 E SOUTHERN AVE
TEMPE AZ
85282-7610
US

V. Phone/Fax

Practice location:
  • Phone: 602-395-0718
  • Fax: 602-277-8146
Mailing address:
  • Phone: 602-395-0718
  • Fax: 602-277-8146

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number23106
License Number StateAZ

VIII. Authorized Official

Name: KAREN LEBER,
Title or Position: ADMINISTRATOR/OWNER
Credential: MD
Phone: 602-395-0718