Tadesse Kebede Debele, MD, MS is a
Student In An Organized Health Care Education/training Program physician based in Kingman, Arizona. Tadesse Kebede Debele is licensed to practice in Arizona (license number R78887) and his current practice location is 2202 N Stockton Hill Rd Ste 101, Kingman, Arizona. He can be reached at his office (for appointments etc.) via phone at
(702) 877-5199.
NPI number for Tadesse Kebede Debele is 1164999660 and his current mailing address is 2202 N Stockton Hill Rd Ste 101, Kingman, Arizona. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1164999660.
Physician's Profile
| Full Name | Tadesse Kebede Debele |
|---|
| Gender | Male |
|---|
| Speciality | Student In An Organized Health Care Education/training Program |
|---|
| Location | 2202 N Stockton Hill Rd Ste 101, Kingman, Arizona |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1164999660
- Provider Enumeration Date: 11/01/2018
- Last Update Date: 04/12/2022
Medical Identifiers
Medical identifiers for Tadesse Kebede Debele such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1164999660 | NPI | - | NPPES |
| 1164999660 | Medicaid | NV | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207Q00000X | Family Medicine | R7887 (Arizona) | Secondary |
| 363A00000X | Physician Assistant | PA2058 (Nevada) | Secondary |
| 390200000X | Student In An Organized Health Care Education/training Program | R78887 (Arizona) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Tadesse Kebede Debele is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Tadesse Kebede Debele, MD, MS
2202 N Stockton Hill Rd Ste 101,
Kingman, AZ 86401-4622
Ph: (928) 681-8701 | Tadesse Kebede Debele, MD, MS
2202 N Stockton Hill Rd Ste 101,
Kingman, AZ 86401-4622
Ph: (702) 877-5199 |
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