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NPI Code Detail

MEDICARE: DR. BARBARA L KOUDELKA NMD

MEDICARE: DR. BARBARA L KOUDELKA NMD
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
1175F00000XNaturopath04-790AZ

General Provider Information

NPI Number : 1770635070
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BARBARA L KOUDELKA NMD
Provider Business Mailing Address
First Line : 41977 W BACCARAT DR
Second Line :
City : MARICOPA
State : AZ
Zip : 85138-3949
Country : US
Telephone Number : 602-463-6823
Fax Number :
Provider Business Practice Location Address
First Line : 21300 N JOHN WAYNE PKWY STE 209
Second Line :
City : MARICOPA
State : AZ
Zip : 85139-8978
Country : US
Telephone Number : 602-855-0640
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/17/2007
Last Update Date : 05/02/2022

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Directions to “ DR. BARBARA L KOUDELKA NMD” Practice Location

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