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General NPI Number Information
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NPI Number | 1164465688
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Entity Type | Individual
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Provider Name | KENNETH L. DIAMOND MD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 11/19/2025
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Provider Practice Location Address
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Address Line | 2400 S AVENUE A
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City | YUMA
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State | AZ
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Zip | 85364-7127
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Country | US
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Telephone | 928-336-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 18123 E MASSAI POINT DR
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City | RIO VERDE
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State | AZ
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Zip | 85263-0023
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Country | US
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Telephone | 954-554-5904
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | ME47970
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 35.144478
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 036-067677
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License Number State | IL
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Taxonomy #4
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 70105
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License Number State | AZ
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