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Individual

PAULA KIESNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
350 W THOMAS RD, PHOENIX, AZ 85013-4409
(602) 406-8798
Mailing address
PO BOX 33269, PHOENIX, AZ 85067-3269
(602) 406-4786
(916) 636-4358

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
006006
AZ
207R00000X
Internal Medicine Physician
R1702
AZ
208M00000X
Hospitalist Physician
Primary
006006
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R1702
TRAINING PERMIT
AZ
Enumeration date
06/17/2009
Last updated
11/06/2024
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