Provider Demographics
NPI:1063479129
Name:YOSOWITZ, LEE SIMON (MD)
Entity Type:Individual
Prefix:DR
First Name:LEE
Middle Name:SIMON
Last Name:YOSOWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:10200 N 92ND ST
Mailing Address - Street 2:SUITE 215
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4534
Mailing Address - Country:US
Mailing Address - Phone:480-657-0308
Mailing Address - Fax:480-451-6945
Practice Address - Street 1:10200 N 92ND ST
Practice Address - Street 2:SUITE 215
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4534
Practice Address - Country:US
Practice Address - Phone:480-657-0308
Practice Address - Fax:480-451-6945
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2008-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ12610207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ860413711Medicare PIN
AZD00600Medicare UPIN