Provider Demographics
NPI:1447210935
Name:LABOVITZ, EARL ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:EARL
Middle Name:ALAN
Last Name:LABOVITZ
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 1:2915 E BASELINE RD
Mailing Address - Street 2:SUITE 121
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234-2425
Mailing Address - Country:US
Mailing Address - Phone:480-507-1997
Mailing Address - Fax:480-507-3638
Practice Address - Street 1:2915 E BASELINE RD
Practice Address - Street 2:SUITE 121
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234-2425
Practice Address - Country:US
Practice Address - Phone:480-507-1997
Practice Address - Fax:480-507-3638
Is Sole Proprietor?:No
Enumeration Date:2006-03-27
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ10075207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ120905OtherPTAN
AZZ120905OtherPTAN