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General NPI Number Information
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NPI Number | 1609107424
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Entity Type | Individual
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Provider Name | DR. DAVID JOHN KUNTZ
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Gender | Male
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Dates
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Enumeration Date | 01/18/2010
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Last Update Date | 02/16/2016
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Provider Practice Location Address
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Address Line | 7219 N LITCHFIELD ROAD INTERNAL MEDICINE CLINIC
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City | LUKE AFB
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State | AZ
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Zip | 85309-1525
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Country | US
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Telephone | 623-856-9705
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Fax |
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Provider Business Mailing Address
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Address Line | 7219 N LITCHFIELD RD
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City | LUKE AFB
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State | AZ
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Zip | 85309-1525
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Country | US
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Telephone | 623-856-9705
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 016632
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License Number State | AZ
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