Organization
MESA EAR NOSE AND THROAT PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS JAMES KETTERER M.D. (PRESIDENT)
(480) 833-8620
Entity
Organization
Contact information
Practice address
726 N GREENFIELD RD # 101, GILBERT, AZ 85234-5012
(480) 833-8620
Mailing address
726 N GREENFIELD RD # 101, GILBERT, AZ 85234-5012
(480) 833-8620
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD18540
AZ
Other
Enumeration date
01/03/2007
Last updated
08/22/2020
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