| Kingfisher Family Medicine, Pllc | |
|
14506 W Granite Valley Dr Ste 123 Sun City West AZ 85375-6012 | |
| (623) 250-2150 | |
| (623) 250-2450 |
| Full Name | Kingfisher Family Medicine, Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 14506 W Granite Valley Dr Ste 123, Sun City West, Arizona |
| Authorized Official Name and Position | Mark Schulke (PHYSICIAN/OWNER) |
| Authorized Official Contact | 6232502150 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kingfisher Family Medicine, Pllc 14506 W Granite Valley Dr Ste 123 Sun City West AZ 85375-6012 Ph: (623) 250-2150 | Kingfisher Family Medicine, Pllc 14506 W Granite Valley Dr Ste 123 Sun City West AZ 85375-6012 Ph: (623) 250-2150 |
| NPI Number | 1366121287 |
|---|---|
| Provider Enumeration Date | 07/17/2023 |
| Last Update Date | 08/09/2023 |
| Medicare PECOS PAC ID | 9638512585 |
|---|---|
| Medicare Enrollment ID | O20240207002184 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366121287 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Mark Schulke |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1922211341 PECOS PAC ID: 1951576099 Enrollment ID: I20201105000742 |
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