Provider Demographics
NPI:1053484352
Name:JUST 4 KIDS PLC
Entity Type:Organization
Organization Name:JUST 4 KIDS PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:PHILLIP
Authorized Official - Middle Name:EUDAILEY
Authorized Official - Last Name:GEAR
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:602-249-9161
Mailing Address - Street 1:5501 N 19TH AVENUE
Mailing Address - Street 2:#400
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85015
Mailing Address - Country:US
Mailing Address - Phone:602-249-9161
Mailing Address - Fax:602-246-2853
Practice Address - Street 1:5501 N 19TH AVENUE
Practice Address - Street 2:#400
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85015
Practice Address - Country:US
Practice Address - Phone:602-249-9161
Practice Address - Fax:602-246-2853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15896208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
D43952Medicare UPIN