JACKRABBIT FAMILY MEDICINE INC NPI 1427258706

NPI Information

NPI: 1427258706
Provider Name: JACKRABBIT FAMILY MEDICINE INC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 03D0971549

Address:
4141 N 32ND ST
SUITE 105
PHOENIX, AZ
ZIP 85018
Phone: (602) 279-2337
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JACKRABBIT FAMILY MEDICINE INC is a primary care clinic center in Phoenix, AZ. JACKRABBIT FAMILY MEDICINE INC NPI is 1427258706. The provider is registered as an organization entity type.

The provider's business location address is:

4141 N 32ND ST
SUITE 105
PHOENIX, AZ
ZIP 85018-775
Phone: (602) 279-2337
Fax: (602) 448-8321

The provider's authorized official is Gabrielle Julie Goodrick .
The authorized official title is President and has the following contact phone number (602) 279-2337.

The CLIA number assigned to this NPI record is 03D0971549 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/24/2007 and was last updated on 1/3/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	22811	ARIZONA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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