Provider Demographics
NPI:1134122575
Name:PEAIRS, CAROL JEAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:JEAN
Last Name:PEAIRS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 30305
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85046-0305
Mailing Address - Country:US
Mailing Address - Phone:602-867-3270
Mailing Address - Fax:602-971-1706
Practice Address - Street 1:4550 E BELL RD
Practice Address - Street 2:BLDG 8 SUITE 276
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-9306
Practice Address - Country:US
Practice Address - Phone:602-867-3270
Practice Address - Fax:602-971-1706
Is Sole Proprietor?:Yes
Enumeration Date:2005-05-31
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ15474207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD37433Medicare UPIN
AZZ73317Medicare PIN