Individual
DR. RICHARD M KOOTMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., P.C.
Contact information
Practice address
13943 N 91ST AVE BLDG G, PEORIA, AZ 85381-3687
(623) 561-1995
(623) 561-2446
Mailing address
13943 N 91ST AVE BLDG G, PEORIA, AZ 85381-3687
(623) 561-1995
(623) 561-2446
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
19610
AZ
Other
Enumeration date
08/08/2006
Last updated
12/05/2007
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