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NPI Code Detail

MEDICARE: DR. KIRK D MINKUS M.D.

MEDICARE: DR. KIRK D MINKUS M.D.
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
12085R0202XDiagnostic Radiology Physician33081AZ
22085R0204XVascular & Interventional Radiology Physician33081AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11Z7086OTHERAZHEALTH NET OF AZ
2AZ0221810OTHERAZBCBSAZ
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164494746
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KIRK D MINKUS M.D.
Provider Business Mailing Address
First Line : 7529 E BASELINE
Second Line : SUITE 101
City : MESA
State : AZ
Zip : 85208
Country : US
Telephone Number : 480-945-4343
Fax Number : 480-945-4350
Provider Business Practice Location Address
First Line : 7529 E BROADWAY RD STE 101
Second Line :
City : MESA
State : AZ
Zip : 85208-2007
Country : US
Telephone Number : 480-945-4343
Fax Number : 480-945-4350
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/07/2006
Last Update Date : 08/27/2025

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