Provider Demographics
NPI:1841273158
Name:PRICE, JESS P (DPM)
Entity type:Individual
Prefix:DR
First Name:JESS
Middle Name:P
Last Name:PRICE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
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Mailing Address - Street 1:1301 S 7TH AVE
Mailing Address - Street 2:400
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85007-3957
Mailing Address - Country:US
Mailing Address - Phone:602-824-3379
Mailing Address - Fax:602-824-4117
Practice Address - Street 1:7331 E OSBORN DR
Practice Address - Street 2:SUITE 230
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85251-6435
Practice Address - Country:US
Practice Address - Phone:480-292-9604
Practice Address - Fax:480-292-9614
Is Sole Proprietor?:No
Enumeration Date:2005-11-22
Last Update Date:2016-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN01057218A213ES0103X
AZ0673213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000371790OtherBC/BS
IN0231480001OtherMEDICARE DME
AZ344979Medicaid
KY80000615Medicaid
IN200521460Medicaid
IN200521460Medicaid
IN200521460Medicaid