Soderberg, Keith C.
Soderberg, Keith C. is an individual health care provider with primary practice located at 2121 N Craycroft Rd Bldg 5 , Tucson AZ 85712-2801. He recently has only one registered license in Allopathic & Osteopathic Physicians / Otolaryngology, which is considered as his primary health care specialty. Soderberg, Keith C. can be contacted via phone (520) 296-8500.Contact Information
Primary practice address
2121 N Craycroft Rd Bldg 5
Tucson AZ 85712-2801
Phone: (520) 296-8500
Fax: (520) 733-2389
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Otolaryngology | 207Y00000X | 29941 | Arizona |
Profile Details
| NPI number | 1770531527 |
|---|---|
| LBN Legal business name | Soderberg, Keith C. |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 4th, 2006 |
| Last updated | Dec 4th, 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 | 1770531527 | NPPES |
| Arizona | MEDICAID | 637887 |
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