Organization
KTL PLASTIC SURGERY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATHEW JAMES (PATIENT ACCOUNTS)
(631) 827-8159
Entity
Organization
Contact information
Practice address
10910 N TATUM BLVD STE B100, PHOENIX, AZ 85028-3080
(631) 827-8159
Mailing address
10910 N TATUM BLVD STE B100, PHOENIX, AZ 85028-3080
(631) 827-8159
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
07/25/2017
Last updated
07/21/2022
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