Provider Demographics
NPI:1033488606
Name:KEZELE, JOSEPH MATHEW (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MATHEW
Last Name:KEZELE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5719 E MILTON DR
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85331-3001
Mailing Address - Country:US
Mailing Address - Phone:480-540-8953
Mailing Address - Fax:
Practice Address - Street 1:5719 E MILTON DR
Practice Address - Street 2:
Practice Address - City:CAVE CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85331-3001
Practice Address - Country:US
Practice Address - Phone:480-540-8953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-27
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10575207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine