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General NPI Number Information
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NPI Number | 1639350648
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Entity Type | Individual
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Provider Name | KSENIJA TOPIC D.P.M.
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Gender | Female
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 01/08/2019
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Provider Practice Location Address
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Address Line | HWY 160 & MP 394.3
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City | KAYENTA
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State | AZ
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Zip | 86033
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Country | US
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Telephone | 928-697-4000
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Fax | 928-697-4145
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Provider Business Mailing Address
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Address Line | PO BOX 368
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City | KAYENTA
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State | AZ
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Zip | 86033-0368
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Country | US
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Telephone | 928-697-4000
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Fax | 928-697-4145
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | 016.005254
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License Number State | IL
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