Provider Demographics
NPI:1205027836
Name:MUNRO, JEFFREY QUINCY (DO)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:QUINCY
Last Name:MUNRO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3805 E BELL RD STE 1600
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2110
Mailing Address - Country:US
Mailing Address - Phone:602-888-4250
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:3805 E BELL RD STE 1600
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-2110
Practice Address - Country:US
Practice Address - Phone:602-888-4250
Practice Address - Fax:000-000-0000
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ006388207R00000X, 207RC0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1205027836OtherNPI
AZ407831Medicaid
AZZ229272OtherMEDICARE