Individual
MR. KURT JAMES TENGBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
13677 W MCDOWELL RD, GOODYEAR, AZ 85338-2618
(623) 882-1500
Mailing address
15881 W STATLER ST, SURPRISE, AZ 85374-5727
(623) 640-3775
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2520
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39-81220
EVERCARE GROUP
AZ
05
—
829137
—
AZ
01
—
AW1436
HEALTHNET GROUP
AZ
Enumeration date
11/02/2005
Last updated
11/13/2007
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