Provider Demographics
NPI:1457105744
Name:VOLKERT, SAVANNAH JO DIMICK (DO)
Entity type:Individual
Prefix:
First Name:SAVANNAH
Middle Name:JO DIMICK
Last Name:VOLKERT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SAVANNAH
Other - Middle Name:JO
Other - Last Name:DIMICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:3100 N CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2637
Mailing Address - Country:US
Mailing Address - Phone:602-344-5011
Mailing Address - Fax:
Practice Address - Street 1:2601 E ROOSEVELT ST
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85008-4973
Practice Address - Country:US
Practice Address - Phone:602-344-5011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-15
Last Update Date:2024-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program