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General NPI Number Information
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NPI Number | 1245347517
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Entity Type | Organization
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Legal Business Name | ADAM R KOELSCH, M.D., P.C.
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Dates
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Enumeration Date | 08/24/2006
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Last Update Date | 11/22/2007
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Provider Practice Location Address
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Address Line | 9522 E SAN SALVADOR DR SUITE 317
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5557
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Country | US
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Telephone | 480-767-1190
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Fax | 480-614-1934
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Provider Business Mailing Address
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Address Line | 9522 E SAN SALVADOR DR SUITE 317
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City | SCOTTSDALE
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State | AZ
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Zip | 85258-5557
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Country | US
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Telephone | 480-767-1190
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Fax | 480-614-1934
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Authorized Official
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Title or Position | PRESIDENT, CEO
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Name | DR. ADAM R KOELSCH
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Credential | M.D.
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Telephone | 480-767-1190
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 31945
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License Number State | AZ
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