Provider Demographics
NPI:1477579159
Name:J. ALAN RAPPAZZO, MD,PC
Entity Type:Organization
Organization Name:J. ALAN RAPPAZZO, MD,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:RAPPAZZO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:480-242-5326
Mailing Address - Street 1:445 E WINDMERE DR
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048-1982
Mailing Address - Country:US
Mailing Address - Phone:480-242-5326
Mailing Address - Fax:480-248-8525
Practice Address - Street 1:445 E WINDMERE DR
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-1982
Practice Address - Country:US
Practice Address - Phone:480-242-5326
Practice Address - Fax:480-248-8525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ13585207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZD00156Medicare UPIN
AZWDBPKMedicare ID - Type Unspecified