Provider Demographics
NPI:1326191115
Name:JEW, JAMES (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:JEW
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 1:3660 W. BETHANY HOME RD.
Mailing Address - Street 2:SUITE A
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85019-1953
Mailing Address - Country:US
Mailing Address - Phone:602-973-3200
Mailing Address - Fax:602-795-3714
Practice Address - Street 1:3660 W. BETHANY HOME RD.
Practice Address - Street 2:SUITE A
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85019-1953
Practice Address - Country:US
Practice Address - Phone:602-973-3200
Practice Address - Fax:602-795-3714
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2019-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19768207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ203238595OtherTAX ID
AZ172445Medicaid
AZ172445Medicaid
AZ105979Medicare PIN