KENNETH LEE SANDOCK M.D. NPI 1841251733

NPI Information

NPI: 1841251733
Provider Name: KENNETH LEE SANDOCK, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
4175 S ALAMO AVE
TUCSON, AZ
ZIP 85707
Phone: (520) 228-2870
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Kenneth Lee Sandock, M.D. is a specialist in Tucson, AZ. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. Kenneth Lee Sandock, M.D. NPI is 1841251733. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4175 S ALAMO AVE
TUCSON, AZ
ZIP 85707-097
Phone: (520) 228-2870

The enumeration date for this NPI number is 3/30/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		01022330A	INDIANA	No
2	174400000X	Specialist		14232	ARIZONA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	E35746	MEDICARE UPIN
2	237017	MEDICAID	ARIZONA
3	Z73570	MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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