Provider Demographics
NPI:1932146073
Name:LIEBERT, JOHN ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:ARTHUR
Last Name:LIEBERT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8700 E PINNACLE PEAK RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3540
Mailing Address - Country:US
Mailing Address - Phone:602-349-0025
Mailing Address - Fax:480-502-9465
Practice Address - Street 1:8700 E PINNACLE PEAK RD
Practice Address - Street 2:SUITE 103
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3540
Practice Address - Country:US
Practice Address - Phone:602-349-0025
Practice Address - Fax:480-502-9465
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2015-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ243782084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A05022Medicare UPIN