Provider Demographics
NPI:1194034702
Name:CHIRCUS, JEFFREY HOWARD (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:HOWARD
Last Name:CHIRCUS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7410 N 71ST PL
Mailing Address - Street 2:
Mailing Address - City:PARADISE VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85253-3527
Mailing Address - Country:US
Mailing Address - Phone:480-609-0661
Mailing Address - Fax:480-609-0664
Practice Address - Street 1:7410 N 71ST PL
Practice Address - Street 2:
Practice Address - City:PARADISE VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85253-3527
Practice Address - Country:US
Practice Address - Phone:480-609-0661
Practice Address - Fax:480-609-0664
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-29
Last Update Date:2010-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0025288208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology