Provider Demographics
NPI:1437257961
Name:DHILLON, KARNAIL S (MD)
Entity Type:Individual
Prefix:
First Name:KARNAIL
Middle Name:S
Last Name:DHILLON
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 1:1000 E INDIAN SCHOOL RD
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-4810
Mailing Address - Country:US
Mailing Address - Phone:602-603-1440
Mailing Address - Fax:602-603-1439
Practice Address - Street 1:1000 E INDIAN SCHOOL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85014-4810
Practice Address - Country:US
Practice Address - Phone:602-603-1440
Practice Address - Fax:602-603-1439
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2017-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ279212084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ203230OtherVALUE OPTIONS RBHA
5637850OtherFIRST HEALTH
AZAZ0788830OtherBCBS
AZ560864Medicaid
AZ203230OtherVALUE OPTIONS RBHA
AZ560864Medicaid