Organization Name: | KENNETH J PREBIL SURGERY ASSOCIATES, P.C. |
NPI Number: | 1619199718 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENNETH J PREBIL (PRESIDENT) |
Mailing Address: | 14155 N. 83rd Ave., Ste. A-105 Peoria |
State: | AZ US |
Postal Code: | 85381 |
Phone Number: | 6234867700 |
Fax Number: | 6234867703 |
NPI Enumeration Date: | 05/02/2007 |
NPI Last Update Date: | 07/31/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | ========= |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | 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. |