Provider Demographics
NPI:1265480644
Name:GROFF, JAMES W (DO)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:W
Last Name:GROFF
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:13943 N 91ST AVE
Mailing Address - Street 2:#C-101
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-3629
Mailing Address - Country:US
Mailing Address - Phone:623-760-9449
Mailing Address - Fax:623-974-9351
Practice Address - Street 1:14506 W GRANITE VALLEY DR
Practice Address - Street 2:124
Practice Address - City:SUN CITY WEST
Practice Address - State:AZ
Practice Address - Zip Code:85375-6010
Practice Address - Country:US
Practice Address - Phone:623-584-2127
Practice Address - Fax:623-584-1257
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2013-10-04
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Provider Licenses
StateLicense IDTaxonomies
AZ2203207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1265480644OtherAHCCCS
AZ99S007000002OtherMEDISUN
AZ188961600OtherDEPT OF LABOR WORK COMP
AZ378796OtherUNITED HEALTHCARE
AZ000378796OtherEVERCARE
AZ070003071OtherRAILROAD MEDICARE
AZ0956762OtherAETNA
AZ113738Medicaid
AZAZ0223100OtherBLUE CROSS BLUE SHIELD
AZ1Z2644OtherHEALTH NET
AZ0956762OtherAETNA
AZ1265480644OtherAHCCCS
AZ378796OtherUNITED HEALTHCARE