Provider Demographics
NPI:1093850042
Name:JOHN STROBL D O PC
Entity Type:Organization
Organization Name:JOHN STROBL D O PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DUKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-561-1151
Mailing Address - Street 1:18205 N 51ST AVE
Mailing Address - Street 2:SUITE 133
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1490
Mailing Address - Country:US
Mailing Address - Phone:623-561-1151
Mailing Address - Fax:623-561-8454
Practice Address - Street 1:18205 N 51ST AVE
Practice Address - Street 2:SUITE 133
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1490
Practice Address - Country:US
Practice Address - Phone:623-561-1151
Practice Address - Fax:623-561-8454
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2010-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ24915Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER