Individual
MR. JOHN PETER KIELEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13640 N PLAZA DEL RIO BLVD, SUITE 220, PEORIA, AZ 85381-4846
(623) 876-3850
(623) 876-3809
Mailing address
13640 N PLAZA DEL RIO BLVD, PEORIA, AZ 85381-4846
(623) 876-3850
(623) 876-3809
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
24317
MN
207R00000X
Internal Medicine Physician
Primary
37509
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0401788
MEDICA
MN
01
—
110043935
RR MEDICARE
MN
05
—
616093000
—
MN
01
—
HP15533
HEALTH PARTNERS
MN
Enumeration date
07/20/2005
Last updated
01/11/2008
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