Provider Demographics
NPI:1598226417
Name:FORBES, JANE
Entity type:Individual
Prefix:
First Name:JANE
Middle Name:
Last Name:FORBES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3104 E CAMELBACK RD UNIT 7947
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4502
Mailing Address - Country:US
Mailing Address - Phone:602-688-4874
Mailing Address - Fax:602-883-8375
Practice Address - Street 1:2441 E WHITTON AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7419
Practice Address - Country:US
Practice Address - Phone:602-688-4874
Practice Address - Fax:602-883-8375
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2025-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101274622207Q00000X
390200000X
AZ73749207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program