| Kieborz Pllc | |
|
3303 S Lindsay Rd Ste 123 Gilbert AZ 85297-2100 | |
| (480) 821-9339 | |
| (480) 821-9555 |
| Full Name | Kieborz Pllc |
|---|---|
| Speciality | Family Medicine |
| Location | 3303 S Lindsay Rd Ste 123, Gilbert, Arizona |
| Authorized Official Name and Position | Timothy J Kieborz (OWNER) |
| Authorized Official Contact | 4808219555 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kieborz Pllc 6722 N 10th Ave Phoenix AZ 85013-1008 Ph: (602) 251-8714 | Kieborz Pllc 3303 S Lindsay Rd Ste 123 Gilbert AZ 85297-2100 Ph: (480) 821-9339 |
| NPI Number | 1962735449 |
|---|---|
| Provider Enumeration Date | 09/15/2009 |
| Last Update Date | 05/13/2020 |
| Medicare PECOS PAC ID | 6406992957 |
|---|---|
| Medicare Enrollment ID | O20091014000175 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962735449 | NPI | - | NPPES |
| 461660 | Medicaid | AZ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 3836 (Arizona) | Primary |
| Provider Name | Timothy J Kieborz |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1629010202 PECOS PAC ID: 2860464633 Enrollment ID: I20040811001001 |
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