Provider Demographics
NPI:1760497325
Name:FISCHBECK, JARON JOSEPH (MD)
Entity Type:Individual
Prefix:
First Name:JARON
Middle Name:JOSEPH
Last Name:FISCHBECK
Suffix:
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 1:16611 S. 40TH ST.,
Mailing Address - Street 2:STE. 120
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85048
Mailing Address - Country:US
Mailing Address - Phone:480-706-4100
Mailing Address - Fax:480-706-2600
Practice Address - Street 1:16611 S 40TH ST
Practice Address - Street 2:SUITE 120
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85048-0562
Practice Address - Country:US
Practice Address - Phone:480-706-4100
Practice Address - Fax:480-706-2600
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ34353207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ973950Medicaid
I45025Medicare UPIN