Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 12769 | AZ |
NPI | 1023009123 |
---|---|
Provider Name | Dr. David Norris Kells |
First Address | Chandler, AZ 85224-5667 |
Second Address | Chandler, AZ 85224-5667 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/10/2005 |
Last Update Date | 12/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
216409 | (05) | AZ |
D37124 | (02) | AZ |
Z137732 | PTAN (01) |