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

Dr. Kenneth W Liechty, MD

Individual provider Surgery Physician · NPI 1588752836

Dr. Kenneth W Liechty, MD is a Pediatric Medicine in Tucson, Arizona. Graduated from University of Utah School of Medicine in 1994, 32 years ago. Practices with Banner-University Medical Group, a 1,071-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Arizona, Colorado, Mississippi and Pennsylvania.

Years since qualifying
32
Trained at
University of Utah School of Medicine
Licensed in
AZ, CO, MS, PA
In the registry since
2006
Specialties on file
4
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

535 N Wilmot Rd Ste 101
Tucson, AZ 85711-2683
Phone: (520) 694-5437
Fax: (520) 874-7070
Show map & directions

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

Additional practice locations (1)

  • 1625 N Campbell Ave, Tucson, AZ 85719-4330 — (520) 694-5437

Specialties & licences

Pediatric Surgery Physician (primary) Taxonomy 2086S0120X · Licence 66494 (AZ)
Surgery Physician Taxonomy 208600000X · Licence MD0598906 (PA)
Pediatric Surgery Physician Taxonomy 2086S0120X · Licence DR.0054069 (CO)
Pediatric Surgery Physician Taxonomy 2086S0120X · Licence 20817 (MS)

Record details

NPI number1588752836
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedOctober 11, 2006
Last updated in NPPESJanuary 8, 2025
Certification dateJanuary 8, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPEDIATRIC MEDICINE
Also practisesGENERAL SURGERY
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 1994 (32 years in practice)
Group practice Banner-University Medical Group — 1071 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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