Provider Demographics
NPI:1669703286
Name:JEFFRIES, MICHELLE L (DO)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:L
Last Name:JEFFRIES
Suffix:
Gender:F
Credentials:DO
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Mailing Address - Street 1:1100 S DOBSON RD STE 223
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-6160
Mailing Address - Country:US
Mailing Address - Phone:480-821-8888
Mailing Address - Fax:480-821-0888
Practice Address - Street 1:1100 S DOBSON RD STE 223
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85286-6160
Practice Address - Country:US
Practice Address - Phone:480-821-8888
Practice Address - Fax:480-821-0888
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-21
Last Update Date:2021-08-25
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Provider Licenses
StateLicense IDTaxonomies
AZ005347207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ545954Medicaid
AZP00858778OtherRAILROAD MEDICARE
AZ1669703286OtherBLUE CROSS BLUE SHIELD
AZ4Z2977OtherHEALTH NET
AZ545954OtherAHCCCS
AZ3873832OtherCIGNA
AZ1669703286OtherBLUE CROSS BLUE SHIELD