Provider Demographics
NPI:1295884336
Name:EMERY, JIMMY DEAN (MD)
Entity type:Individual
Prefix:
First Name:JIMMY
Middle Name:DEAN
Last Name:EMERY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2475 E GLEN CANYON RD
Mailing Address - Street 2:
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-6361
Mailing Address - Country:US
Mailing Address - Phone:520-398-6861
Mailing Address - Fax:520-398-6861
Practice Address - Street 1:2475 E GLEN CANYON RD
Practice Address - Street 2:
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-6361
Practice Address - Country:US
Practice Address - Phone:520-398-6861
Practice Address - Fax:520-398-6861
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2013-05-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ47674207Q00000X
CAG32707207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine