Provider Demographics
NPI:1326015728
Name:SIBLEY, ELENA (MD)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:
Last Name:SIBLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9977 N 90TH ST
Mailing Address - Street 2:STE 178
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4426
Mailing Address - Country:US
Mailing Address - Phone:480-947-7401
Mailing Address - Fax:480-946-5565
Practice Address - Street 1:9977 N 90TH ST
Practice Address - Street 2:STE 178
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4426
Practice Address - Country:US
Practice Address - Phone:480-947-7401
Practice Address - Fax:480-946-5565
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-03
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ21357208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ136938OtherAHCCCS
AZ136938OtherAHCCCS
F57796Medicare UPIN