Provider Demographics
NPI:1487186144
Name:STEIL, KENNETH (DO)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:
Last Name:STEIL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:KENNY
Other - Middle Name:
Other - Last Name:STEIL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:10960 N 128TH WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-4425
Mailing Address - Country:US
Mailing Address - Phone:480-577-8189
Mailing Address - Fax:
Practice Address - Street 1:7725 N 43RD AVE STE 720
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85051-5772
Practice Address - Country:US
Practice Address - Phone:623-207-5465
Practice Address - Fax:623-207-5405
Is Sole Proprietor?:No
Enumeration Date:2017-03-31
Last Update Date:2021-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ007744207N00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207N00000XAllopathic & Osteopathic PhysiciansDermatology