Provider Demographics
NPI:1679726103
Name:ANDRY, JAMES PHILLIP (MD, MS, BS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:PHILLIP
Last Name:ANDRY
Suffix:
Gender:M
Credentials:MD, MS, BS
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:PHILLIP
Other - Last Name:ANDRY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:3815 E BELL RD STE 2200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85032-2139
Mailing Address - Country:US
Mailing Address - Phone:602-633-3848
Mailing Address - Fax:602-633-3841
Practice Address - Street 1:9834 GENESEE AVE STE 228
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1215
Practice Address - Country:US
Practice Address - Phone:858-455-9942
Practice Address - Fax:858-455-6473
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC173003207X00000X
AZ47603207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ214310OtherMEDICARE
AZ833650Medicaid
CACB372818Medicaid