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Individual

THOMAS C. KUPKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
BANNER BAYWOOD MEDICAL CENTER, 6644 E. BAYWOOD AVE, MESA, AZ 85206-1797
(480) 321-2000
Mailing address
1741 E MORTEN AVE, SUITE C-1, PHOENIX, AZ 85020-4645
(602) 870-0194

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
18704
AZ

Other

Enumeration date
06/29/2006
Last updated
07/30/2007
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