Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 005850 | AZ |
N | 2081P2900X | Pain Medicine | 005850 | AZ |
NPI | 1427071026 |
---|---|
Provider Name | Kerry Tobias |
First Address | Phoenix, AZ 85004 |
Second Address | Phoenix, AZ 85004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/07/2006 |
Last Update Date | 25/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
683683 | (05) | AZ |