Provider Demographics
NPI:1245251701
Name:FRANKEL, JAY S (MD)
Entity type:Individual
Prefix:DR
First Name:JAY
Middle Name:S
Last Name:FRANKEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3707 N 7TH ST STE 200
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85014-5095
Mailing Address - Country:US
Mailing Address - Phone:602-242-2555
Mailing Address - Fax:602-242-5415
Practice Address - Street 1:20033 N 19TH AVE
Practice Address - Street 2:SUITE 106
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-4245
Practice Address - Country:US
Practice Address - Phone:602-242-2555
Practice Address - Fax:602-242-5415
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2014-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11260174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ21119401Medicaid
AZD36863Medicare UPIN
AZZ64634Medicare PIN