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General NPI Number Information
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NPI Number | 1902851389
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Entity Type | Individual
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Provider Name | KENNETH V SALCE M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 04/27/2011
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Provider Practice Location Address
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Address Line | 77 W. FOREST AVENUE SUITE 101
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-1482
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Country | US
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Telephone | 928-773-2515
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Fax | 928-773-2240
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Provider Business Mailing Address
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Address Line | DEPT 2018 PO BOX 29675
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City | PHOENIX
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State | AZ
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Zip | 85038-9675
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Country | US
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Telephone |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 17547
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License Number State | AZ
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