Individual
ADAM KEITH BOETTCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1020 N SAN FRANCISCO ST STE 200, FLAGSTAFF, AZ 86001-3281
(928) 774-2300
Mailing address
1020 N SAN FRANCISCO ST STE 200, FLAGSTAFF, AZ 86001-3281
(928) 774-2300
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
4301090356
MI
2086S0122X
Plastic and Reconstructive Surgery Physician
45896
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P707631
—
AZ
Enumeration date
06/26/2007
Last updated
01/29/2020
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