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NPI Code Detail

MEDICARE: DR. KATHLEEN MARIE DUERKSEN M.D.

MEDICARE:  DR. KATHLEEN MARIE DUERKSEN  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
1207WX0200XOphthalmic Plastic and Reconstructive Surgery Physician21767AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417966607
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN MARIE DUERKSEN M.D.
Provider Business Mailing Address
First Line : 5979 E GRANT RD
Second Line : SUITE 115
City : TUCSON
State : AZ
Zip : 85712
Country : US
Telephone Number : 520-751-8030
Fax Number : 520-751-0990
Provider Business Practice Location Address
First Line : 5979 E GRANT RD
Second Line : SUITE 115
City : TUCSON
State : AZ
Zip : 85712
Country : US
Telephone Number : 520-751-8030
Fax Number : 520-751-0990
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/05/2006
Last Update Date : 11/11/2016

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Directions to “ DR. KATHLEEN MARIE DUERKSEN M.D.” Practice Location

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