Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0204X | Pediatric Emergency Doctor | 3323 | AZ |
NPI | 1114009164 |
---|---|
Provider Name | Dr. Donald Lee Kane |
First Address | Tucson, AZ 85712-5601 |
Second Address | Tucson, AZ 85712-2805 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
571936 | AHCCCS (01) | AZ |
571936-07 | (05) | AZ |
I20700 | (02) |