MEDICARE: DR. JOLENE N KUTY DC

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	111NI0900X	Internist Chiropractor	7653	AZ
2	111N00000X	Chiropractor	7653	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	Z112346	OTHER	AZ	MEDICARE ID-PIN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	Z112345	OTHER	AZ	GROUP PIN

General Provider Information

NPI Number	:	1558309252
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOLENE N KUTY DC

Provider Business Mailing Address
First Line	:	6634 E ASTER DR
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254
Country	:	US
Telephone Number	:	480-945-7800
Fax Number	:	480-945-7805

Provider Business Practice Location Address
First Line	:	6634 E ASTER DR
Second Line	:
City	:	SCOTTSDALE
State	:	AZ
Zip	:	85254
Country	:	US
Telephone Number	:	480-945-7800
Fax Number	:	480-945-7805

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

Provider Enumeration Date	:	06/03/2006
Last Update Date	:	08/11/2015

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Directions to “ DR. JOLENE N KUTY DC” Practice Location

Language	Start Address	Practice Location

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