Provider Demographics
NPI:1477291276
Name:PIRKLE, JESSICA BETHANY (MD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:BETHANY
Last Name:PIRKLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6021 E OAK ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-4653
Mailing Address - Country:US
Mailing Address - Phone:602-373-5377
Mailing Address - Fax:
Practice Address - Street 1:3950 S COUNTRY CLUB RD STE 130
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-2203
Practice Address - Country:US
Practice Address - Phone:520-874-2778
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-23
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR79528207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine