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General NPI Number Information
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NPI Number | 1588972889
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Entity Type | Individual
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Provider Name | GLENN RICHARD KUNSMAN DO
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Gender | Male
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Dates
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Enumeration Date | 09/21/2010
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Last Update Date | 09/27/2022
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Provider Practice Location Address
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Address Line | 6120 W BELL RD STE 100
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City | GLENDALE
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State | AZ
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Zip | 85308-3780
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Country | US
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Telephone | 833-263-3426
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Fax | 866-264-4120
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Provider Business Mailing Address
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Address Line | 6120 W BELL RD STE 100
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City | GLENDALE
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State | AZ
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Zip | 85308-3780
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Country | US
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Telephone | 833-263-3426
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Fax | 866-264-4120
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | DO1822
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | Q5012
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 005538
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 005538
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License Number State | AZ
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