Individual
KENNETH LEE SANDOCK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4175 S ALAMO AVE, TUCSON, AZ 85707-6097
(520) 228-2870
Mailing address
8311 E CRESTWOOD CIR, TUCSON, AZ 85750-2413
(520) 298-4677
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
01022330A
IN
174400000X
Specialist
Primary
14232
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
237017
—
AZ
Enumeration date
03/30/2006
Last updated
07/08/2007
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