Provider Demographics
NPI:1578741591
Name:JERI B HASSMAN MD PC
Entity Type:Organization
Organization Name:JERI B HASSMAN MD PC
Other - Org Name:CALMWOOD MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JERI
Authorized Official - Middle Name:BARBARA
Authorized Official - Last Name:HASSMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-319-1919
Mailing Address - Street 1:250 S CRAYCROFT RD STE 400
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-3834
Mailing Address - Country:US
Mailing Address - Phone:520-319-1919
Mailing Address - Fax:520-917-2040
Practice Address - Street 1:250 S CRAYCROFT RD STE 400
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-3834
Practice Address - Country:US
Practice Address - Phone:520-319-1919
Practice Address - Fax:520-917-2040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-31
Last Update Date:2020-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ16132208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ69041Medicare PIN