Provider Demographics
NPI:1376558775
Name:KU, PHILIP L (MD)
Entity Type:Individual
Prefix:
First Name:PHILIP
Middle Name:L
Last Name:KU
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Gender:M
Credentials:MD
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Mailing Address - Street 1:10440 E RIGGS RD
Mailing Address - Street 2:STE 160
Mailing Address - City:SUN LAKES
Mailing Address - State:AZ
Mailing Address - Zip Code:85248-7751
Mailing Address - Country:US
Mailing Address - Phone:480-895-7600
Mailing Address - Fax:480-895-7601
Practice Address - Street 1:10440 E RIGGS RD
Practice Address - Street 2:STE 160
Practice Address - City:SUN LAKES
Practice Address - State:AZ
Practice Address - Zip Code:85248-7751
Practice Address - Country:US
Practice Address - Phone:480-895-7600
Practice Address - Fax:480-895-7601
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2008-07-24
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Provider Licenses
StateLicense IDTaxonomies
AZ28134207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
H40846Medicare UPIN