Basic Information
| Provider Information | |||||||||
| NPI: | 1609118322 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KASER | ||||||||
| FirstName: | SCOTT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 645 E MISSOURI AVE | ||||||||
| Address2: | STE 300 | ||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850121351 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6022628900 | ||||||||
| FaxNumber: | 6022628890 | ||||||||
| Practice Location | |||||||||
| Address1: | 2200 BERGQUIST DR STE 1 | ||||||||
| Address2: | WHMC/GE-2200 | ||||||||
| City: | JBSA LACKLAND AFB | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782365300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2105132991 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2013 | ||||||||
| LastUpdateDate: | 07/19/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 07/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 61887 | AZ | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 208D00000X | 28382 | NE | N | Allopathic & Osteopathic Physicians | General Practice |
No ID Information.