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NPI Code Detail

MEDICARE: KATHLEEN KELLOGG MD

MEDICARE: KATHLEEN KELLOGG 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
1207R00000XInternal Medicine Physician50662AZ

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 : 1437296795
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN KELLOGG MD
Provider Business Mailing Address
First Line : PO BOX 31235
Second Line :
City : TUCSON
State : AZ
Zip : 85751-1235
Country : US
Telephone Number : 520-324-4100
Fax Number : 520-324-1406
Provider Business Practice Location Address
First Line : 10350 E DREXEL RD UNIT 110
Second Line :
City : TUCSON
State : AZ
Zip : 85747-9409
Country : US
Telephone Number : 520-324-1727
Fax Number : 520-324-1700
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2007
Last Update Date : 09/13/2021

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Directions to “ KATHLEEN KELLOGG MD” Practice Location

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