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

Paul D Koelliker, MD

Individual provider Emergency Medicine Physician · NPI 1417921453

Paul D Koelliker, MD is an Emergency Medicine in Parker, Arizona. Qualified in 1996, 30 years ago. Practices with Dhhs Phs Naihs Crownpoint Hospital, a 50-clinician group and accepts Medicare assignment. Licensed in New Mexico.

Years since qualifying
30
Licensed in
NM
In the registry since
2006
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

12033 Agency Rd
Parker, AZ 85344-7718
Phone: (928) 669-3353
Fax: (928) 669-3131
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence 2001-235 (NM)

Record details

NPI number1417921453
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedFebruary 15, 2006
Last updated in NPPESJune 8, 2026
Certification dateJune 8, 2026

Medicare enrollment

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

Medicare specialtyEMERGENCY MEDICINE
Medical schoolOTHER
Graduated 1996 (30 years in practice)
Group practice Dhhs Phs Naihs Crownpoint Hospital — 50 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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