Individual provider · NPI-1

Dr. Robert L Kistner Jr., M.D.

Surgery · Bullhead City, AZ

NPI number1063404572
StatusActive
Last updated in NPPESMar 13, 2024

Details

NPI
1063404572
Entity type
Individual (NPI-1)
Name
Dr. Robert L Kistner Jr.
Credential
M.D.
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 19, 2005
Certification date
Mar 13, 2024
Last updated
Mar 13, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208600000X Surgery35056109OHYes
174400000X SpecialistAZ20804AZ

Practice location

2755 Silver Creek Rd Ste 111
Bullhead City, AZ 86442-8343

Phone 928-704-7163

Mailing address

Po Box 50970
Phoenix, AZ 85076-0970

Phone 480-706-6151 · Fax 480-706-8908

Other practice locations

1909 E Ray Rd Ste 9-154
Chandler, AZ 85225-8735

Phone 480-706-6151 · Fax 480-706-8908

Is something wrong?

This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.

Other Surgery providers in Bullhead City, AZ