Provider Demographics
NPI:1558781831
Name:PADIYAR, JOSNA P (DO)
Entity Type:Individual
Prefix:
First Name:JOSNA
Middle Name:P
Last Name:PADIYAR
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 W THOMAS RD STE 500
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85013-4220
Mailing Address - Country:US
Mailing Address - Phone:602-406-4000
Mailing Address - Fax:602-406-6498
Practice Address - Street 1:500 W THOMAS RD STE 500
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85013-4220
Practice Address - Country:US
Practice Address - Phone:602-406-4000
Practice Address - Fax:602-406-6498
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-24
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ007883207R00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty