MEDICARE: DR. KELSIE ELIZABETH OATMEN 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
1	208000000X	Pediatrics Physician	R77367	AZ
2	208000000X	Pediatrics Physician	66295	AZ

General Provider Information

NPI Number	:	1316400583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELSIE ELIZABETH OATMEN MD

Provider Business Mailing Address
First Line	:	4801 E BROADWAY BLVD STE 251
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85711-2700
Country	:	US
Telephone Number	:	520-795-4783
Fax Number	:	520-547-5797

Provider Business Practice Location Address
First Line	:	1925 W ORANGE GROVE RD STE 109
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85704-1150
Country	:	US
Telephone Number	:	520-751-3675
Fax Number	:	520-547-5767

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2019
Last Update Date	:	06/19/2026

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