Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ktl Plastic Surgery

Organization Plastic Surgery Physician · NPI 1053834739

Ktl Plastic Surgery is a Plastic Surgery Physician in Phoenix, Arizona. Registered with an NPI since 2017.

In the registry since
2017

Practice location Address checks out

10910 N Tatum Blvd Ste B100
Phoenix, AZ 85028-3080
Phone: (631) 827-8159
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Plastic Surgery Physician (primary) Taxonomy 208200000X

Record details

NPI number1053834739
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Mathew James — Patient Accounts · (631) 827-8159
NPI enumeratedJuly 25, 2017
Last updated in NPPESJuly 21, 2022
Mailing address10910 N Tatum Blvd Ste B100, Phoenix, AZ 85028-3080

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