Boettcher, Adam Keith
Boettcher, Adam Keith is an sole proprietor health care provider with primary practice located at 1020 N San Francisco St Ste 200 , Flagstaff AZ 86001-3281. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Boettcher, Adam Keith can be contacted via phone (928) 774-2300.Contact Information
Primary practice address
1020 N San Francisco St Ste 200
Flagstaff AZ 86001-3281
Phone: (928) 774-2300
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Plastic and Reconstructive Surgery | 2086S0122X | 45896 | Arizona |
| Allopathic & Osteopathic Physicians / Surgery | 208600000X | 4301090356 | Michigan |
Profile Details
| NPI number | 1134325012 |
|---|---|
| LBN Legal business name | Boettcher, Adam Keith |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 26th, 2007 |
| Last updated | Jan 29th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1134325012 | NPPES |
| Arizona | MEDICAID | P707631 |
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