Actinodermatology Ltd

NPI 1063695252 - Dermatology - 207N00000X

NPI Details
NPI 1063695252
Enumeration Date 12/11/2007
Last Updated 04/01/2010
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name JERRY A JERRY
Position PRESIDENT
Phone (480) 839-1767
Fax
Practice Location
2600 E SOUTHERN AVE
#A-2
TEMPE AZ, 85282-7610, US
Phone (480) 839-1767
Fax
Business Location
2600 E SOUTHERN AVE
#A-2
TEMPE AZ, 85282-7610, US
Phone (480) 839-1767
Fax
Toxanomy
Taxonomy Code 207N00000X
License State Arizona
License Number 7979
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According to our database, Actinodermatology Ltd NPI is 1063695252, taxonomy code is 207N00000X and license number is 7979, license state is located at Arizona. Actinodermatology Ltd physically located at 2600 E Southern Ave, Tempe AZ, 85282-7610. NPI Number 1033115704 has the healthcare provider type.

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1063695252 NPI number is provided on an as is basis without warranty of any kind. 1063695252 is maintained by the National Plan & Provider Enumeration System. The contents of Actinodermatology Ltd are for informational purposes only.