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NPI Code Detail

MEDICARE: VICKI KALEN MD

MEDICARE: VICKI KALEN MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12086S0120XPediatric Surgery Physician34452AZ

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10Z126262OTHERAZMEDICARE PTAN
17Z126263OTHERAZMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11376731851OTHERAZGROUP NPI
21588843734OTHERAZGROUP NPI
31750579439OTHERAZGROUP NPI
41831387315OTHERAZGROUP NPI
51033398201OTHERAZGROUP NPI
61770771255OTHERAZGROUP NPI
71033307715OTHERAZGROUP NPI
81457543324OTHERAZGROUP NPI
9Z120952OTHERGROUP PTAN
111740479518OTHERAZGROUP NPI
121871782490OTHERAZGROUP NPI
131396933974OTHERAZGROUP NPI
141447448923OTHERAZGROUP NPI
15Z126048OTHERAZGROUP PTAN
161780873307OTHERAZGROUP NPI

General Provider Information

NPI Number : 1073588547
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICKI KALEN MD
Provider Business Mailing Address
First Line : 3402 E BROADWAY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85716-5406
Country : US
Telephone Number : 520-881-0050
Fax Number :
Provider Business Practice Location Address
First Line : 3402 E BROADWAY BLVD
Second Line :
City : TUCSON
State : AZ
Zip : 85716-5406
Country : US
Telephone Number : 520-881-0050
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2006
Last Update Date : 03/13/2009

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Directions to “ VICKI KALEN MD” Practice Location

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