Provider Demographics
NPI:1518901974
Name:HAZEL, PALPU NONE (MD)
Entity Type:Individual
Prefix:DR
First Name:PALPU
Middle Name:NONE
Last Name:HAZEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:MRS
Other - First Name:BEVERLY
Other - Middle Name:
Other - Last Name:FAIRCHILD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7514 E MONTEREY WAY
Mailing Address - Street 2:SUITE # 4
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6900
Mailing Address - Country:US
Mailing Address - Phone:480-949-5700
Mailing Address - Fax:480-949-8976
Practice Address - Street 1:7514 E MONTEREY WAY
Practice Address - Street 2:SUITE # 4
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6900
Practice Address - Country:US
Practice Address - Phone:480-949-5700
Practice Address - Fax:480-949-8976
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ113752084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ254855-03Medicaid
AZ254855-03Medicaid
AZMD11375Medicare ID - Type Unspecified