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General NPI Number Information
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NPI Number | 1639341795
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Entity Type | Individual
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Provider Name | GENEVIE LOREE KOCOUREK M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2008
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Last Update Date | 12/13/2024
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Provider Practice Location Address
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Address Line | 6501 E GREENWAY PKWY # 103-449
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City | SCOTTSDALE
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State | AZ
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Zip | 85254-2025
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Country | US
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Telephone | 480-714-5692
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Fax | 888-372-3577
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Provider Business Mailing Address
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Address Line | 27925 N WALNUT CREEK RD
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City | RIO VERDE
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State | AZ
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Zip | 85263-5243
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Country | US
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Telephone | 480-714-5692
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Fax | 888-372-3577
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | CDR.0000875
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20336
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11961125-1205
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License Number State | UT
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 62177
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License Number State | AZ
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Taxonomy #5
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 53754
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License Number State | WI
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