Provider Demographics
NPI:1477511913
Name:SOBEL, JERRY BRIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JERRY
Middle Name:BRIAN
Last Name:SOBEL
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 1:4550 E BELL RD
Mailing Address - Street 2:#114
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-9306
Mailing Address - Country:US
Mailing Address - Phone:602-385-4160
Mailing Address - Fax:602-385-4151
Practice Address - Street 1:4550 E BELL RD
Practice Address - Street 2:#110
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85032-9306
Practice Address - Country:US
Practice Address - Phone:602-385-4160
Practice Address - Fax:602-385-4151
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2015-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG840432081P2900X
AZ231742081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F107587Medicare UPIN