Provider Demographics
NPI:1487675153
Name:HRKAL, MILAN MILOSLAV III (MD)
Entity Type:Individual
Prefix:DR
First Name:MILAN
Middle Name:MILOSLAV
Last Name:HRKAL
Suffix:III
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 1:21321 E OCOTILLO RD
Mailing Address - Street 2:STE 110
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85242-5996
Mailing Address - Country:US
Mailing Address - Phone:480-677-4545
Mailing Address - Fax:480-677-4356
Practice Address - Street 1:21321 E.OCOTILLO RD.
Practice Address - Street 2:STE.110
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85242
Practice Address - Country:US
Practice Address - Phone:480-677-4545
Practice Address - Fax:480-677-4356
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2009-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ36321208000000X
SC18670208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC186701Medicaid
AZ204815Medicaid
G19898Medicare UPIN