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General NPI Number Information
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NPI Number | 1831324714
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Entity Type | Organization
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Legal Business Name | ANN KIMMEL M.D. LLC
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Dates
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Enumeration Date | 05/21/2009
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Last Update Date | 05/21/2009
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Provider Practice Location Address
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Address Line | 1520 S DOBSON RD SUITE #315
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City | MESA
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State | AZ
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Zip | 85202-4725
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Country | US
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Telephone | 480-962-9345
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Fax | 480-962-9379
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Provider Business Mailing Address
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Address Line | 1520 S DOBSON RD SUITE #315
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City | MESA
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State | AZ
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Zip | 85202-4725
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Country | US
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Telephone | 480-962-9345
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Fax | 480-962-9379
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. MAYRA SALAZAR
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Credential |
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Telephone | 480-962-9345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 29961
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License Number State | AZ
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