Provider Demographics
NPI:1972896918
Name:MIDTOWN ENDOCRINE ASSOCIATES PC
Entity Type:Organization
Organization Name:MIDTOWN ENDOCRINE ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:JOAN F BAILEY M.D. P.C.
Authorized Official - Prefix:
Authorized Official - First Name:JOAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:BAILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-258-9955
Mailing Address - Street 1:2200 N 3RD ST
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85004-1401
Mailing Address - Country:US
Mailing Address - Phone:602-258-9955
Mailing Address - Fax:602-258-9933
Practice Address - Street 1:2200 N 3RD ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85004-1401
Practice Address - Country:US
Practice Address - Phone:602-258-9955
Practice Address - Fax:602-258-9933
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2013-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZA221768207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ153388Medicaid
AZ153388Medicaid