KK Mukkavilli PLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

MD29911 Issued in AZ

Legal business name

KK MUKKAVILLI PLC

Practice address

3333 E Indian School Rd
Suite 4
Phoenix, AZ 85018-5015

Phone

(602) 852-0200

Fax

(888) 959-8755

NPI assigned

Jul 5, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lee Pollock

Title

Office Manager

Phone

(801) 949-6730

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kamakshi K Mukkavilli, MD

  • Internal Medicine Physician
  • Mesa, AZ
  • NPI 1508983644

  Geriatric Medicine

  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1341446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1345420800000",
    "number": "1033474119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 E INDIAN SCHOOL RD",
            "address_2": "SUITE 4",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185015",
            "telephone_number": "602-852-0200",
            "fax_number": "888-959-8755"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3333 E INDIAN SCHOOL RD",
            "address_2": "SUITE 4",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850185015",
            "telephone_number": "602-852-0200",
            "fax_number": "888-959-8755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KK MUKKAVILLI PLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-07-05",
        "last_updated": "2012-08-20",
        "status": "A",
        "authorized_official_last_name": "POLLOCK",
        "authorized_official_first_name": "LEE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "801-949-6730"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AZ",
            "license": "MD29911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kitterman Enterprises Inc.
• Alison Domenica Kitzerow, OD
• Beverly Kitzman
• Alvaro Kiyama
• Beatrice Lea Kjelland, RN
• KKC Southwest, LLC
• Joseph V Klag, DO
• Kristin N Klamar, PAC
• Jason Klarer, LAC
• Kathleen E Klas, P.N.P., R.N.F.A.

• Geriatric Medicine (Internal Medicine) Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Geriatric Medicine (Internal Medicine) Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.