Provider Demographics
NPI:1609835180
Name:RAIFE, JOHN H JR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:H
Last Name:RAIFE
Suffix:JR
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:PO BOX 15070
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85267-5070
Mailing Address - Country:US
Mailing Address - Phone:480-421-9700
Mailing Address - Fax:480-421-9899
Practice Address - Street 1:1111 E MCDOWELL RD
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85006-2612
Practice Address - Country:US
Practice Address - Phone:602-839-6968
Practice Address - Fax:602-839-4144
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2015-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ9460207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ249781Medicaid
AZ249781Medicaid
AZ249781Medicaid