Provider Demographics
NPI:1093959744
Name:MACHUZAK, JOSEPH S (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:S
Last Name:MACHUZAK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:7161 E RANCHO VISTA DR UNIT 3004
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-1655
Mailing Address - Country:US
Mailing Address - Phone:267-235-1023
Mailing Address - Fax:928-233-8917
Practice Address - Street 1:3101 CLEARWATER DR STE C
Practice Address - Street 2:
Practice Address - City:PRESCOTT
Practice Address - State:AZ
Practice Address - Zip Code:86305
Practice Address - Country:US
Practice Address - Phone:928-202-4143
Practice Address - Fax:928-233-8917
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-25
Last Update Date:2019-03-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ3753207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZH52929Medicare UPIN
78553Medicare PIN