Provider Demographics
NPI:1942270947
Name:REISER, JANET R (MD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:R
Last Name:REISER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7331 E OSBORN DR
Mailing Address - Street 2:SUITE 250
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85251-6435
Mailing Address - Country:US
Mailing Address - Phone:480-646-8444
Mailing Address - Fax:480-646-8445
Practice Address - Street 1:7331 E OSBORN DR
Practice Address - Street 2:SUITE 250
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6435
Practice Address - Country:US
Practice Address - Phone:480-646-8444
Practice Address - Fax:480-646-8445
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-24
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ29358207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ588535Medicaid
AZ74101Medicare ID - Type Unspecified
AZF14311Medicare UPIN
AZ102952Medicare ID - Type Unspecified