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General NPI Number Information
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NPI Number | 1538356894
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Entity Type | Organization
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Legal Business Name | HENRY H KALDENBAUGH MD PC
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Dates
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Enumeration Date | 10/01/2007
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Last Update Date | 01/21/2010
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Provider Practice Location Address
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Address Line | 214 S MAIN ST
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City | COTTONWOOD
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State | AZ
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Zip | 86326-3907
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Country | US
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Telephone | 928-634-7534
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Fax |
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Provider Business Mailing Address
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Address Line | 214 S MAIN ST
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City | COTTONWOOD
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State | AZ
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Zip | 86326-3907
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Country | US
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Telephone | 928-634-7534
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. NICOL MOODY
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Credential |
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Telephone | 928-634-7534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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