Provider Demographics
NPI:1003267030
Name:KEDING, AMY ELIZABETH (OD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:ELIZABETH
Last Name:KEDING
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:7501 E MCDOWELL RD APT 3181
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85257-3575
Mailing Address - Country:US
Mailing Address - Phone:847-370-5985
Mailing Address - Fax:
Practice Address - Street 1:8752 E SHEA BLVD STE 125
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85260
Practice Address - Country:US
Practice Address - Phone:480-991-6432
Practice Address - Fax:480-991-2143
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-30
Last Update Date:2019-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ2122152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist