Provider Demographics
NPI:1508846627
Name:SIEFER, JAMES R (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:SIEFER
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:2730 S VAL VISTA DR
Mailing Address - Street 2:BLDG.#13, SUITE 177
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85295-1675
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:485 S DOBSON RD
Practice Address - Street 2:SUITE 103
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-5603
Practice Address - Country:US
Practice Address - Phone:480-963-2026
Practice Address - Fax:480-963-5841
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2012-06-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ1930208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ921694Medicaid
AZ921694Medicaid