Provider Demographics
NPI:1922074012
Name:LABOWITZ, JODIE K (MD)
Entity Type:Individual
Prefix:DR
First Name:JODIE
Middle Name:K
Last Name:LABOWITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:JODIE
Other - Middle Name:K
Other - Last Name:ABRAMS
Other - Suffix:VIII
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3020 NE CAMELBACK RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-5095
Mailing Address - Country:US
Mailing Address - Phone:602-264-9100
Mailing Address - Fax:602-264-9101
Practice Address - Street 1:5823 W EUGIE AVE
Practice Address - Street 2:STE A
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85304-1276
Practice Address - Country:US
Practice Address - Phone:602-843-1265
Practice Address - Fax:602-843-1297
Is Sole Proprietor?:No
Enumeration Date:2006-02-27
Last Update Date:2017-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ26966207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ120390OtherGROUP MEDICARE NUMBER
AZ317047OtherGROUP MEDICAID NUMBER
AZ439621 01Medicaid
AZ439621 01Medicaid
AZ120392Medicare PIN
AZ120390OtherGROUP MEDICARE NUMBER