Provider Demographics
NPI:1366445280
Name:STEMMER, JASON L (MD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:L
Last Name:STEMMER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6080 N LA CHOLLA BLVD # 200
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85741-3533
Mailing Address - Country:US
Mailing Address - Phone:520-797-8550
Mailing Address - Fax:520-797-6986
Practice Address - Street 1:6080 N LA CHOLLA BLVD # 200
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85741-3533
Practice Address - Country:US
Practice Address - Phone:520-797-8550
Practice Address - Fax:520-797-6986
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ15516207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ22674OtherPREFERRED HEALTH NETWORK
AZ10055690OtherPPO NEXT
AZ116500Medicaid
AZ87660OtherFIRST HEALTH
AZ100668OtherONE HEALTH
AZ1Z2849OtherHEALTH NET
AZ5033185OtherCCN
AZAZ0860410OtherBCBS OF ARIZONA
AZ38-00005OtherUNITED HEALTHCARE
AZ4140OtherARIZONA MEDICAL NETWORK
AZ005502302OtherCIGNA
AZ2591552OtherGHI
AZ360004138OtherRAILROAD MEDICARE
CAXPY198499Medicaid
AZ4663616OtherAETNA
AZ116500Medicaid
AZ87660OtherFIRST HEALTH
AZ360004138OtherRAILROAD MEDICARE
CAXPY198499Medicaid