Provider Demographics
NPI:1659561637
Name:DONALD JOSEPH AUBREY M.D., PC
Entity Type:Organization
Organization Name:DONALD JOSEPH AUBREY M.D., PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ADELLA
Authorized Official - Middle Name:
Authorized Official - Last Name:CORDOVA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:623-326-1055
Mailing Address - Street 1:14555 N SCOTTSDALE RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85254-3400
Mailing Address - Country:US
Mailing Address - Phone:480-951-2888
Mailing Address - Fax:480-951-3888
Practice Address - Street 1:14555 N SCOTTSDALE RD
Practice Address - Street 2:SUITE 250
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3400
Practice Address - Country:US
Practice Address - Phone:480-951-2888
Practice Address - Fax:480-951-3888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ30033261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ705147Medicaid
AZ705147Medicaid