Provider Demographics
NPI:1972599066
Name:JAFFE, DAVID F (DPM)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:F
Last Name:JAFFE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13949 W MEEKER BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:SUN CITY WEST
Mailing Address - State:AZ
Mailing Address - Zip Code:85375-4436
Mailing Address - Country:US
Mailing Address - Phone:623-975-8397
Mailing Address - Fax:623-546-3704
Practice Address - Street 1:13949 W MEEKER BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-4436
Practice Address - Country:US
Practice Address - Phone:623-975-8397
Practice Address - Fax:623-546-3704
Is Sole Proprietor?:No
Enumeration Date:2005-09-23
Last Update Date:2012-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ0468213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00307291OtherMEDICARE RAILROAD
AZ379992001Medicaid
AZAZ0402890OtherBLUE CROSS BLUE SHIELD
AZ5672150001Medicare NSC
AZP00307291OtherMEDICARE RAILROAD
U65237Medicare UPIN