Provider Demographics
NPI:1891014726
Name:TARTAGLIA, JENNIFER (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:TARTAGLIA
Suffix:
Gender:F
Credentials:MD
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 40908
Mailing Address - Street 2:SUITE 331
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28309-0908
Mailing Address - Country:US
Mailing Address - Phone:910-615-6949
Mailing Address - Fax:910-615-9761
Practice Address - Street 1:1521 E TANGERINE RD
Practice Address - Street 2:SUITE 331
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-6225
Practice Address - Country:US
Practice Address - Phone:520-901-6355
Practice Address - Fax:520-901-6354
Is Sole Proprietor?:No
Enumeration Date:2010-05-17
Last Update Date:2016-10-18
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Provider Licenses
StateLicense IDTaxonomies
AZ48241207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology