S WALTER KMIECIK


Address: 18404 N Tatum Blvd Ste 101, Phoenix, AZ 85032-1511
Phone: 6024857421

S WALTER KMIECIK (NPI# 1396858742) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1396858742
Entity Type Individual
Full Name S WALTER KMIECIK
Credential MD
Practice Address 18404 N Tatum Blvd Ste 101
Phoenix
AZ 85032-1511
Mailing Address 2500 W Utopia Rd
Ste. 100
Phoenix
AZ 85027-4171
Practice Telephone 6024857421
Practice Fax Number 6024857440
Mailing Telephone 6022146148
Mailing Fax Number 6022146149
Enumeration Date 2006-08-17
Last Update Date 2013-09-25
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 207Q00000X Family Medicine 27134 AZ Allopathic & Osteopathic Physicians

Other Provider Identifier

State Issuer Identifier Type Code
AZ RAILROAD MEDICARE PIN P00428272 01

Office Location

Street Address 18404 N TATUM BLVD STE 101
City PHOENIX
State AZ
Zip Code 85032-1511

Providers in the same location

NPI Name Taxonomy Address Enumeration
1851336432 Honorhealth Medical Group, LLC Psychologist 18404 N Tatum Blvd Ste 101, Phoenix, AZ 85032-1511 2006-06-18
1124439856 Michael Luong Family Medicine 18404 N Tatum Blvd Ste 101, Phoenix, AZ 85032-1511 2014-05-15
1063623262 Linda Rita Makdesi Internal Medicine 18404 N Tatum Blvd Ste 101, Phoenix, AZ 85032-1511 2007-05-28
1861530222 Honorhealth Medical Group, LLC Audiologist 18404 N Tatum Blvd Ste 101, Phoenix, AZ 85032-1511 2007-02-01

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1689298838 Eboni Nicole Morris Psychologist 166001 N. 40th St., Suite 210, Phoenix, AZ 85032 2020-06-03
1326688573 Genoa Healthcare, LLC Durable Medical Equipment & Medical Supplies 3227 E Bell Road, Suite 170, Room P1, Phoenix, AZ 85032 2020-01-15
1740836642 Integrated Medical Services Inc Internal Medicine 3815 W Bell Rd, Ste 3200, Phoenix, AZ 85032 2019-08-15
1639739576 Sarah Martin Physical Therapy Assistant Ridgecrest Healthcare, 16640 North 38th Street, Phoenix, AZ 85032 2019-06-13
1750846168 Conte Sport Performance Therapy LLC Physical Therapist 18413 N. Cave Creed Rd, Suite 8, Phoenix, AZ 85032 2019-02-11
1659848208 Pacific Dental Services Foundation Physician Assistant 4559 E. Bell Road, Ste 106, Phoenix, AZ 85032 2018-10-31
1083100812 Phoenix Interventional Pain Management, Pllc Anesthesiology 3815 E Bell Rd Ste 3500a, Phoenix, AZ 85032 2018-07-04
1770074635 Np Professional LLC Clinic/Center 3329 E Bell Rd Ste A1, Phoenix, AZ 85032 2018-05-25
1932600020 North Phoenix Asc LLC Clinic/Center 3329 E Bell Rd Ste A2-a5, Phoenix, AZ 85032 2018-02-23
1396263307 Cheryl Anne Miller Registered Nurse 15002 N. 32nd St., Phoenix, AZ 85032 2017-08-30
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1194339200 Madison Le Family Medicine 3037 W Cat Balue Dr, Phoenix, AZ 85027-2342 2020-09-04
1720604069 Good Health Medical, PC Family Medicine 2632 S 83rd Ave Ste 113, Phoenix, AZ 85043-7206 2020-06-23
1427670751 Florence Wellness Pllc Family Medicine 101 E Washington St Fl 7, Phoenix, AZ 85004-2450 2020-05-08
1437782257 Jillian Knapp Family Medicine 521 W Butler Dr, Phoenix, AZ 85021-4526 2020-02-20
1861033912 Vanessa Lissette Lara Family Medicine 1459 E Flower St, Phoenix, AZ 85014-5666 2019-09-30
1366007411 Marceline E Ndum Family Medicine 10631 S. 51st Street, Suite 1, Phoenix, AZ 85044-5225 2019-05-03
1306318340 Leah Margaret Hillier Family Medicine 1300 N 12th St - Suite 500, Phoenix, AZ 85006 2018-12-31
1326510389 Leanne J Muniz Family Medicine 19635 N Cave Creek Rd Apt 344, Phoenix, AZ 85024-1879 2018-12-31
1164905535 Clark Medical, Pllc Family Medicine 2601 N 3rd St Ste 106, Phoenix, AZ 85004-1144 2018-09-12
1780180901 Babymoon Inn Family Care LLC Family Medicine 202 E Morris Dr, Phoenix, AZ 85012-2323 2018-04-05
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Competitor

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City PHOENIX
Zip Code 85032

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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